The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule updating Medicare policies and providing payments for services furnished under the Medicare Physician Fee Schedule (PFS) in CY 2020.Medicare Physician Fee Schedule (MPFS) Proposals Payment Changes to Office/Outpatient Evaluation and Management (E/M) Services Reducing coding complexity by consolidating CPT coding from 5 levels to 4 levels for office/outpatient E/M visits for new patients Improving payment for office/outpatient E/M visits, and establish a new add-on code for prolonged service time. Consolidating the Medicare-specific add-on code in primary care and non-procedural care into a single code for ongoing care …

In accordance with Section 4009 of H.R. 34-21st Century Cures Act (Public Law No: 114-255), CMS is updating the “Medicare Program Integrity Manual” with detailed changes to the LCD process. These changes were communicated in CMS Transmittal 863, issued on 2/12/2019.Please be aware of the LCD revisions and transition of all coding to related articles. There has been no change in coverage associated with this update. All coding information, will be removed from the LCDs and placed in a related billing and coding article, including national coverage provisions, and associated information (documentation requirements, utilization guidelines). The article name will begin …

CSMS is now accepting nominations for the 2019 Maloney Distinguished Service Award. All CSMS members are welcome to nominate their colleagues for recognition of outstanding work.The Paul K. Maloney, Jr., MD Distinguished Service Award was established to honor the life and work of Dr. Maloney, an eminent physician known for his exemplary service, active engagement, and dedication to the community. The Maloney Award is the highest honor CSMS can confer upon a member. Each year, CSMS donates $1,000 to the charity of the Maloney Award winner’s choice.The nomination deadline is Friday, August 23, 2019. Your nomination should include your contact …

CSMS signed onto an AMA letter, with dozens of specialty and state medical societies throughout the country, to show unity throughout the federation of medicine concerning surprise billing. The letter was directed at the Energy and Commerce Chair, Frank Pallone, Jr. and Ranking Member Greg Walden and the members of the Committee on Energy and Commerce ahead of the Wednesday mark-up.Federation Sign on Letter Surprise Billing 7-16-19.The CSMS, in conjunction with other state medical societies, the AMA, Physicians Advocacy Institute and national medical specialty societies, will continue to reach out to our US Representatives and US Senators throughout the August …

Now Available: 2018 MIPS Performance Feedback and Final Score Now Available: MIPS Targeted Review 2020 MIPS Self-Nomination Materials Now AvailableNow Available: 2018 MIPS Performance Feedback and Final ScoreIf you submitted 2018 Merit-based Incentive Payment System (MIPS) data, you can now view your performance feedback and MIPS final score on the Quality Payment Program website.You can access your 2018 MIPS performance feedback and final score by: Going to cms.gov/login Logging in using your HCQIS Access Roles and Profile (HARP) system credentials; these are the same credentials that allowed you to submit your 2018 MIPS dataIf you don’t have a HARP account, …

CMS published several new resources: Cost Category and Quality Category User Guides provide additional technical details on how to participate in each of these categories. MIPS Eligibility Decision Tree helps physicians determine if they are eligible or exempt from MIPS participation. 2019 QP Methodology Fact Sheet provides an overview of how CMS makes QP and PQ determinations for Advanced APM participation.PAI’s QPP Resource Center and the CMS QPP Resource Library has additional resources on MIPS and Advanced APMs.

PAI Comments on CMS and ONC Proposed Rules on Interoperability and Increasing Patient Access to their Health InformationEarlier this year, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) released two proposed rules on interoperability, information blocking, and patient access to their health information: CMS Proposed Rule – Interoperability and Patient Access for Medicare Advantage Organization and Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans in the Federally-Facilitated Exchanges and Health Care Providers ONC Proposed Rule – 21st Century Cures Act: Interoperability, …

The Merit-based Incentive Payment System (MIPS) Promoting Interoperability category (formerly known as the Advancing Care Information category) changed significantly from previous years. Some of the key changes include: Revised to contain a single set of objectives and measures for reporting; Required use of 2015 edition certified electronic health record technology (CEHRT); and A new scoring methodology for the category that eliminates the base, performance, and bonus score components.Notably, the category features hardship exceptions, which allow reweighting to 0 percent and have the 25 percent weight reallocated to the quality category (for a final weight of 70 percent of the final …

HUGE Step Forward on High Deductible Health Plan Fight! We're thrilled that our tireless efforts to get the legislature to address HDHPs paid off. The budget includes the establishment of a task force, as specially requested by our HDHP coalition, to study high deductible health plans. The task force will include members of CSMS, Connecticut College of Emergency Physicians (CCEP) and other physicians, and will be convened by the Healthcare Advocate, reporting its findings before the next session.CSMS, CCEP, and many specialty and county medical associations were involved in this campaign, proving that organized medicine is effective and powerful! Connecticut …

CSMS EVP/CEO Matthew Katz, recently participated in a National Government Services (NGS) listening session and would like to share some insight, tips, and tools with members. See the list below to learn about the NGS updated website, Medicare identification cards, duplicate claims, annual wellness visits, and updates on revalidation. The NGS website has been updated and it is best for physicians and their staff to register on the site in order to access all of the information available to them. The contact us tab now provides a way to reach key NGS staff specific to Connecticut. Unfortunately, in some places …

https://qpp.cms.gov/about/resource-library - Quality Payment Programhttps://www.cms.gov/About-CMS/story-page/patients-over-paperwork.html - Patients Over Paperworkhttps://www.cms.gov/Outreach-and-Education/Medicare-Learning-NetworkMLN/MLNGenInfo/Continuing-Education.html - Medicare Learning Network Continuing Educationhttps://www.cms.gov/Outreach-and-Education/Look-Up-Topics/Medicare/New-Medicare-CardMessage.html - New Medicare Cardhttps://innovation.cms.gov/initiatives/medicare-diabetes-prevention-program/ - Medicare Diabetes Prevention Programhttps://www.cms.gov/Medicare/Medicare-Fee-for-ServicePayment/DMEPOSCompetitiveBid/index.html - DMEPOS Competitive Biddinghttps://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/index.html - Physician Fee Schedule/Care Managementhttps://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-andReports/Medicare-Provider-Charge-Data/OpioidMap.html - Opioidshttps://www.cms.gov/Medicare/Quality-Initiatives-Patient-AssessmentInstruments/HospitalQualityInits/HospitalCompare.html - Hospital Compare Star Ratingshttps://www.cms.gov/Regulations-andGuidance/Legislation/EHRIncentivePrograms/2019ProgramRequirementsMedicare.html - Interoperability of Electronic Health Information

CSMS is one of more than 120 physicians’ advocacy organizations that signed a letter that was sent to congressional leaders to urge them to refine and improve the Medicare Access and CHIP Reauthorization Act (MACRA), including replacing the 2020-2025 physician payment update freeze with positive payment adjustments, extending the Advanced APM bonus payments by six years, and implementing several technical improvements.Click here to read the letter. Click for AMA MACRA Statutory Changes Recommendations Summary

On June 3, CSMS and the Physician’s Advocacy Institute (PAI) submitted comments to Office of the National Coordinator for Health Information Technology (ONC Health IT) and Centers for Medicare & Medicaid Services (CMS) regarding the 21st Century Interoperability Proposed Rule.Click here to read the letter sent to CMS.Click here to read the letter sent to ONC.

Group comprises 7 State Medical Associations with more than 180,000 physician and student membersNORTH HAVEN, CT -- With pressure mounting on state legislatures across the country to legalize recreational marijuana, a coalition of eight* state Medical Societies is calling for thoughtful and thorough consideration before rushing to legislate.“This is a public health issue, not a tax issue,” said Thomas Madejski, MD, immediate past president of the Medical Society of the State of New York. “It’s ludicrous to prioritize increased state revenue against increased hospital visits. The health of our citizens is at stake here.”Indeed, data from states that have legalized …

Proposal backed by Congressional Physician-Members Would Protect Patients, Hold Insurers Accountable and Avoid Costly Legal BattlesNORTH HAVEN, CT. -- The Connecticut State Medical Society (CSMS) applauds the announcement of bipartisan legislation authored by physician representatives Raul Ruiz, MD, (D-CA), Phil Roe, MD, (R-TN), Ami Bera, MD (D-CA), Larry Bucshon, MD (R-IN) and Joseph Morelle (D-NY), Van Taylor (R-TX), Donna Shalala (D-FL), and Brad Wenstrup (R-OH) to protect patients and end surprise medical bills.Based on the successful law in the state of New York, this important proposal will protect patients from the financial hardship and emotional stress of surprise medical bills …

The May issue of Connecticut Medicine, the peer-reviewed scientific journal of the Connecticut State Medical Society (CSMS), “Finding Hope in the Battle Against the Opioid Overdose Crisis,” highlights some of the innovative strategies Connecticut’s medical community is forging to tackle this public health crisis and features dozens of experts from across the state, including: Regional Neonatal Abstinence Syndrome Education Increases Provider Knowledge. This informative piece was written by: GINA BURROWS, RN, MSN, APRN, CATHERINE WAGNER, EdD, MARK S. DEFRANCESCO, MD, MBA, JOHN F. GREENE, JR., MD, LISA HONIGFELD, PhD, CHRISTOPHER M. MOROSKY, MD, MS, KATRIONA CASAGRANDE, BA, AND MARY REICH …

Due to the current increase in measles cases in the United States, the Centers for Disease Control and Prevention has developed the following summary for vaccination of adults against measles with measles, mumps, rubella (MMR) vaccine. Recommendations for vaccination and assessing immunity in adults have not changed since publication of the Advisory Committee on Immunization Practices (ACIP) recommendations for the Prevention of Measles, Rubella, Congenital Rubella syndrome, and Mumps in June 2013. (https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6204a1.htm)WHAT ADULT PROVIDERS NEED TO KNOW:• Providers do not need to actively screen adult patients for measles immunity. This is because of high population immunity and low risk …

The May issue of Connecticut Medicine, the peer-reviewed scientific journal of the Connecticut State Medical Society (CSMS), “Finding Hope in the Battle Against the Opioid Overdose Crisis,” highlights some of the innovative strategies Connecticut’s medical community is forging to tackle this public health crisis and features dozens of experts from across the state.Guest editor, J. Craig Allen, MD, Medical Director of Rushford and Vice President of Addiction Services at Hartford HealthCare’s Behavioral Health Network, wrote an article about the opioid overdose crisis in Connecticut.ABSTRACT – In October of 2017, the impact of the opioid crisis on the nation led the …

State participates in the largest investment of private funds to assist physicians with sharing health information across medical practicesThe Connecticut State Medical Society (CSMS) in association with five other state medical societies and The Physicians Foundation, today announced the formation of the first of its kind $500,000 interoperability fund, known as The Physicians Foundation Interoperability Fund, which will assist medical practices in effectively sharing clinical information with other physicians and hospitals through health information exchanges (HIE). Funding is available for physicians in participating states with an electronic health record system (EHR) and will be allocated to practices on a first …

Connecticut Attorney General Tong is leading a 44-state coalition antitrust lawsuit against TEVA Pharmaceuticals, 19 other generic drug manufacturers, 15 individuals in conspiracy to fix prices and allocate markets for more than 100 different generic drugs.Today, the Connecticut State Medical Society joined several legislators and other key health care advocates for a press conference to learn more about this lawsuit, and to applaud the Attorney General’s efforts.According to the President Elect of the Connecticut State Medical Society (CSMS), Bollepalli Subbarao, MD, who was at today’s press conference, “CSMS has had significant concern, for many years, regarding the rapid growth in …