CMS Releases Proposed Rule for 2022 Medicare Physician Fee Schedule
Yesterday, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the 2022 Medicare physician fee schedule. The American Medical Association (AMA) staff is in the process of analyzing and developing a summary of the 1,700+ page proposal but in the meantime, there is a key issue of which physicians need to be aware. Notably, the 2022 Medicare conversion factor would be reduced by approximately 3.89% from $34.8931 to $33.5848.
This is largely a result of the expiration of a 3.75% increase to the conversion factor at the end of calendar year 2021, as averted for 2021 by Congressional action. The AMA will strongly advocate that Congress avert this significant cut and extend the 3.75% increase for 2022. Please note that the impact table in the proposed rule does not seem to include the 3.75% reduction in the conversion factor.
The text of the proposed rule can be accessed here, and several other links are below:
- CMS Press Release
- Physician Fee Schedule Fact Sheet
- QPP Fact Sheet (please note this is different from the link in the press release, which was broken)
Medicare Increases Payment for Cognitive Care
Alzheimer’s dementia affects one in nine people age 65 and older and kills more than breast and prostate cancer combined. The Centers for Medicare & Medicaid Services has taken steps to address this public health crisis by increasing payment for and expanding access to cognitive assessment and care plan services.
Effective January 1, 2021, Medicare increased payment for these services to $282 (may be geographically adjusted) when provided in an office setting, added these services to the definition of primary care services in the Medicare Shared Savings Program, and permanently covered these services via telehealth.
4 Things to Know About the Cognitive Assessment & Care Plan Services
- If your patient shows signs of cognitive impairment at an Annual Wellness Visit (AWV) or other routine visit, you may perform a more detailed cognitive assessment and develop a care plan
- The Cognitive Assessment & Care Plan Services (CPT code 99483) typically start with a 50-minute face-to-face visit that includes a detailed history and patient exam, resulting in a written care plan
- If you report evaluation and management (E/M) services, you can offer this service, including: physicians (MD and DO), nurse practitioners, clinical nurse specialists, and physician assistants.
- Use CPT code 99483 to bill for this service. Part B coinsurance and deductible apply. You may bill this code separately from the AWV.
For More Information
Please review more detail on Medicare coverage requirements and billing standards at www.cms.gov/cognitive.
For more information on assessing cognitive impairment, please refer to the Alzheimer’s and Dementia Resources for Professionals webpage here.
More on New York State Employer Safety Plans Required by August 5
As reported last week, the New York State Department of Labor put forth model forms for all New York employers to follow in adopting required airborne infectious disease exposure prevention standards in response to legislation enacted into law (the New York Health and Essential Rights Act – NY HERO Act) earlier this year. The law requires all employers regardless of size to have extensive new workplace health and safety protections in response to the COVID-19 pandemic. The statute requires that employers adopt a safety plan within 30 days of the Department of Labor posting the model forms (August 5). After adopting a plan, the employer is required to share the safety plan with employees within 30 days.
As a follow up to the article, MSSNY has been advised by the New York State Department of Labor that “the standard published by the Department provides that it does not apply to ‘Any employee within the coverage of a temporary or permanent standard adopted by the Occupational Safety and Health Administration setting forth applicable standards regarding COVID-19 and/or airborne infectious agents and diseases.’ As such, employers within the coverage of the current OSHA ETS (which is currently limited to healthcare) are not currently required to take action or adopt a plan pursuant to the NY HERO Act.”
Therefore, whether a physician’s office is required to follow the federal OSHA ETS or the NY DOL standard may be on a case-by-case basis. As noted in the recent alert by MSSNY’s General Counsel, the Garfunkel Wild law firm, OSHA Issues Emergency Rules for Healthcare Employers and Updated Guidance for All Employers | Garfunkel Wild, exempted from compliance with the OSHA ETS are “employers performing healthcare services on an outpatient basis in a non-hospital setting, if non-employees are screened prior to entry and people with suspected or confirmed COVID-19 are not permitted to enter.”
Physicians should consult with their legal counsel for how best to ensure their offices comply with these state and/or federal requirements.
New York County Medical Society Honors Leaders at June 23, 2021 Annual Meeting
During its June 23rd Annual Meeting, the New York County Medical Society (NYCMS) honored outgoing president Arthur Cooper, MD and welcomed incoming president Keith LaScalea, MD. Dr. LaScalea graduated from SUNY – Binghamton and the University of Chicago Pritzker School of Medicine, completed his residency in Internal Medicine at New York Presbyterian Hospital, and is on the faculty in the Division of Internal Medicine at Weill Cornell Medicine.
In addition to his clinical practice as a primary care physician he is involved in teaching, curriculum development, and holds multiple roles in the College administration. On July 12, 2021, Doctor LaScalea was listed as one of Crain’s New York Business “Notables in Health Care.”
NYCMS also welcomed officers Erick Eiting, MD, President–Elect; Thomas Sterry, MD, Vice President; Jessica J. Krant, MD, MPH, Secretary; and Jill R. Baron, MD, Treasurer. Loren Wissner Greene, MD and Stuart Gitlow, MD serve as Assistant Secretary and Assistant Treasurer respectively.
Milton Haynes, MD Receives Nicholas Romayne, MD Lifetime Achievement Award
During the NYCMS annual meeting, incoming president Dr. LaScalea presented Milton Haynes, MD with the Nicholas Romayne, MD Lifetime Achievement Award—which is named for the Society’s first president and recognizes exceptional contribution to the Society.
Dr. Haynes, who served as president of the Society in 2000 – 2001, is a graduate of Howard University College of Medicine, is board certified by the American Board of Obstetrics and Gynecology, and is a fellow of the American College of Obstetricians and Gynecologists. Prior to his retirement, Dr. Haynes was in private practice, a Senior Attending at Lenox Hill Hospital, and Attending at North General Hospital. He was Clinical Associate Professor of Obstetrics and Gynecology, New York University Medical Center.
Dr. Haynes served as Chair of MSSNY’s Committee on Healthcare Disparities, and as a member of the AMA Commission to Eliminate Racial and Ethnic Healthcare Disparities.
In honoring the many contributions of Dr. Haynes to the medical profession, Dr. LaScalea called him a “creative disrupter” who “brought the concepts of diversity, equity, and inclusion light years ahead of their time.”
NYC Seeing Rise in COVID-19 Cases as Delta Variant Spreads Further
Bloomberg (7/12, Querolo) reports COVID-19 cases “in New York City are climbing for the first time in months as the delta variant gains traction and vaccination rates in some boroughs remain stubbornly low.” New York City’s “seven-day average rate of positive tests has risen slowly throughout July, and had roughly doubled in two weeks to 1.27% as of Saturday.” On average, “there were 328 new confirmed and probable cases daily over the past week, up from 208 as of June 28.” The New York Post (7/12, Marsh, Raskin) reports “Staten Island is experiencing an uptick in COVID-19 cases at least partly because of the recent spread of the highly contagious Delta variant among unvaccinated New Yorkers.”
COVID-19 Vaccination Enrolled Providers: Please Update Contact Information for Excelsior Pass Applications
Excelsior Pass mobile application is New York State’s voluntary and secure way to retrieve and present digital proof of COVID-19 vaccination or negative COVID-19 test results. In order for users to retrieve the vaccination pass, their vaccination data within NYSIIS/CIR must be correct and up-to-date. Providers are responsible for entering all vaccination data and remediating any data errors for users who report difficulty in retrieving their pass. For more information on what to look for and how to fix data errors, please review this factsheet.
Some vaccinated individuals have been reporting difficulty obtaining their Excelsior Pass. Beginning this week, an e-mail will be sent to these individuals directing them to review their vaccination record with their provider. The e-mail will direct individuals to their vaccination provider by giving them the provider’s primary and secondary points of contact and contact information as it was submitted on the provider’s COVID-19 Vaccination Program enrollment form, unless updated information has been submitted by the provider entity. If the contact information is outdated or there is a better point of contact who can assist vaccinated individuals with review and correction of their vaccination record, please submit updated information here.
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