CMS Proposes Historic Changes to Modernize Medicare and Restore the Doctor-Patient Relationship

CMS Press Release (07/12/18)

In an effort to streamline the paperwork that clinicians encounter when billing Medicare, the Centers for Medicare & Medicaid Services (CMS) has proposed rules to encourage clinicians to use their electronic health records (EHRs) to better document clinically meaningful information, not just billing information. The proposals, part of the Physician Fee Schedule (PFS) and the Quality Payment Program (QPP), would modify the Merit-based Incentive Payment System (MIPS) "Promoting Interoperability" performance category to support greater EHR interoperability, patient access to their health data, and position the program with the proposed new "Promoting Interoperability" initiative for hospitals. In addition, the proposed changes would pay doctors for their time when they connect with beneficiaries virtually by telephone or other telecommunications devices to assess whether an in-person visit is needed. CMS estimates the proposed changes to the PFS would save clinicians more than 50 hours annually each if 40 percent of their patients are in Medicare, while the proposed QPP changes could save more than 29,000 hours overall and $2.6 million in lower administrative costs next year. CMS also suggested waivers of MIPS requirements as part of testing the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI). According to CMS, "The MAQI demonstration would test waiving MIPS reporting requirements and payment adjustments for clinicians who participate sufficiently in Medicare Advantage arrangements that are similar to Advanced APMs."

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