News: CMS releases final 2017 physician payment rule

CDI Strategies - Volume 10, Issue 47

Physician payment rates will increase 0.24% for 2017 compared to 2016, according to the 2017 Physician Fee Schedule Final Rule, released by CMS on November 3. This increase comes after application of the 0.5% payment increase required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and mandated budget neutrality cuts, says CMS.

This major final rule addresses changes to the physician fee schedule and other Medicare Part B payment policies. CMS finalized its proposals to pay for new telehealth services, including end-stage renal disease-related services for dialysis, advance care planning services and critical care consultations, and to expand the Medicare Diabetes Prevention Program model.

In addition, CMS finalized its proposals to require healthcare providers and suppliers to be screened and enrolled in Medicare to contract with a Medicare Advantage organization.

This provision will begin two years after publication of the final rule and will be effective on the first day of the plan year.

Other proposals finalized by CMS include:

  • Changes to the quality measurement requirements of the Medicare Shared Savings Program (MSSP), which include revisions to the measure set and quality data validation process.
  • A change to allow individual eligible professionals participating in MSSP to report quality data separately for the purposes of the Physician Quality Reporting System, and to have that data used in PQRS in the event the MSSP Accountable Care Organization fails to report quality data
  • Updates to the informal review process used in the physician value modifier program.

Click here to read the final rule.

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