Dec. 6, 2015
Vol. 4, No. 65
provides comments to CMS regarding the implementation of MIPS
In a recent letter to the Centers for Medicare &
Medicaid Services (CMS), TMA President, Tom Garcia, MD, cites TMA's
concerns that the myriad of compliance, documentation and reporting
requirements that will be implemented in the future Medicare system
will have little, if any impact on improving health care quality or
TMA's letter was submitted in response to a CMS request
for information regarding the implementation of the Merit-Based
Incentive Payment System or MIPS, promotion of alternative payment
models and incentive payments for participation in eligible
alternative payment models as published in the Oct. 1, 2015 Federal
To read the full text of TMA's letter, along with
supporting documents, click
local discussion on this and other practice management and advocacy
topics, consider joining the BCMS Legislative and Socioeconomics
Committee by contacting Mary Nava.
by Dec. 16 to avoid Medicare pay cut of 2-4 percent
Practices that may have thought they were safe from
Medicare payment penalties next year could be in for an unpleasant
surprise if they don't take action now.
Problems with how the Centers for Medicare & Medicaid Services
(CMS) has been collecting and analyzing data related to the Physician
Quality Reporting System (PQRS) and the value-based payment modifier
are leading to inappropriate penalties of 2-4 percent of Medicare
payments for thousands of physicians.
How to avoid
the penalty: File
an informal review request with CMS before midnight Eastern
time Dec. 16. CMS has said it will verify incentive eligibility and
payment adjustment determinations for practices that file such a
Additional information about the process and contact information for
questions is available in CMS' informal
review fact sheet.
CMS has said the informal review system will be down Dec. 3-7 and
unable to accept requests during that time.
shouldn't be this way? We agree. That's why the
American Medical Association (AMA) is pressing CMS to rectify the
impossible situation in which it has placed physicians.
Child Abuse and Neglect in 2016
The Public Health and Patient
Advocacy Committee at BCMS is looking for
doctors who would like to volunteer their time to support efforts to
better address issues of child abuse and child neglect in Bexar and
the surrounding counties.
This adjunct committee would focus on researching the
issue, collecting data, looking at what is already being done
locally, what is being done elsewhere that has been effective and
then making recommendations to the full committee.
The PH&PA Committee meets on the first Wednesday of
every odd month at the BCMS offices. For more information or to
volunteer to participate please
contact committee liaison Mike Thomas at 210-582-6399.
BCMS OFFICER INSTALLATION
say CMS payment rule could shut down their labs
Summary of article from Modern Healthcare:
If the Centers for Medicare and Medicaid Services (CMS) goes forward
with a new payment proposal for clinical diagnostic tests it could
lead to labs closing and beneficiaries losing access to tests,
healthcare providers warn.
The new proposal would pay Medicare rates the same as
private insurance rates for clinical diagnostic tests.
The new laboratory payment rates would result in a $360
million loss for laboratories in 2017 and a potential Medicare
savings of more than $5.14 billion.
Thomas Nickels, executive vice president at AHA said in
a comment letter that reduced payments would lead to lab closures and
lack of patient access.
Dr. Charles Hill, president of the Association for
Molecular Pathology, an international medical association
representing over 2,300 physicians involved with laboratory testing,
spoke out against the proposal.
"The addition of complicated reporting
requirements, in conjunction with the statutory penalty for failure
or incorrect reporting, would potentially discourage hospitals from
providing molecular pathology testing and other reportable testing
in-house, resulting in a substantial decrease in access to testing
for Medicare beneficiaries and a decrease in patient choice over
critical healthcare decisions."
The agency is expected to finalize the rule by year's end based on a
timeline outlined in the rule.
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