American Association of Clinical Endocrinologists

Proposed Rule for the 2018 Medicare Physician Fee Schedule Released

Following the July 4th holiday, the Centers for Medicare and Medicaid Services (CMS) released the annual proposed rule for the 2018 Medicare Physician Fee Schedule (MPFS). Among the proposals on calendar year 2018 payment policies, CMS is seeking public comment on reducing administrative burdens for providing patient care, including visits, care management, and telehealth services.

For example, CMS is specifically calling for a multi-year effort to revise the Evaluation and Management Guidelines and is suggesting a focus on eliminating guidelines related to history and physical examination, with greater importance placed on medical decision-making and time spent performing the service. The rule also seeks to better align incentives and provide clinicians with a smoother transition to the new Merit-based Incentive Payment System. In addition, the proposed rule makes additional proposals to implement the Medicare Diabetes Prevention Program expanded model starting in 2018. Click here to read a fact sheet on the proposed rule and click here to read the proposed rule.

AACE submitted a comment letter on the proposed rule that included input on many issues of interest to members. AACE advocated for a more practical evaluation and management code level system based mostly on medical decision making; easing regulatory burdens associated with prior authorization, prohibitions on continuous glucose monitoring devises, and face-to-face requirements for insulin pump supplies; implementation of the Medicare Diabetes Prevention Program (DPP), including support for a virtual DPP; and limiting penalties for the value-based payment modifier feedback program. Click here to view the entire AACE comment letter.

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