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Proposed CMS rule overhauls E/M visit codes, reduces modifier 25 payment

June 12, 2018

The Centers for Medicare and Medicaid Services (CMS) today released its proposed 2019 Medicare Physician Fee Schedule rule, which also includes changes to its proposed policies for the 2019 Quality Payment Program (QPP) established under the Medicare Access and CHIP Reauthorization Act (MACRA). In addition to proposing an overhaul of evaluation and management (E/M) visits, the AADA is very concerned that CMS also is proposing a payment reduction for E/M visits billed with a procedure.

AADA staff continues analyzing the proposed rule and plans to submit comments to CMS by Sept. 10, 2018. This Academy webpage includes the AADA's initial topline analysis of the proposed rule, and will be updated with additional details following further review. Information will also be made available in Dermatology World Weekly.


AADA comments on 2018 Medicare physician fee schedule & Quality Payment Program/MACRA rules

December 29, 2017

The AADA submitted comments on the 2018 Medicare Physician Fee Schedule final rule as well as the final rule for the 2018 Quality Payment Program (QPP), established under the Medicare Access and CHIP Reauthorization Act (MACRA). Both rules were released by the Centers for Medicare and Medicaid Services in November.

Click here to read the AADA's comments on the 2018 Medicare Physician Free Schedule rule.

Click here to read comments on the 2018 Quality Payment Program/MACRA rule.


2018 Medicare physician fee schedule & Quality Payment Program/MACRA rules out today, House passes IPAB repeal

November 2, 2017 

The Centers for Medicare and Medicaid Services (CMS) today released the 2018 Medicare Physician Fee Schedule rule as well as the final rule for the 2018 Quality Payment Program (QPP), established under the Medicare Access and CHIP Reauthorization Act (MACRA). CMS indicates these rules reflect the agency’s broader strategy of relieving regulatory burdens for providers, particularly for small and solo practices. Additionally, the U.S. House of Representatives today passed legislation repealing the Independent Payment Advisory Board (IPAB), which would be charged with making significant cuts to Medicare when government spending on the program reaches a certain threshold. Much of what is being announced today reflects wins for the Academy, and is a result of the AADA’s regulatory relief priority and advocacy over the past 10 months.

Read the AADA breaking news alert with more information. While the House today passed legislation repealing IPAB, it is unclear whether the Senate will also act. Send a letter to your Senators in favor of IPAB repeal through the AADA’s Advocacy Action Center.


AADA sends regulatory relief recs to Medicare Red Tape Relief Project

August 25, 2017 

The American Academy of Dermatology Association (AADA) today sent a letter to the U.S. House Ways and Means Committee offering recommendations for the Committee’s Medicare Red Tape Relief Project ― an initiative that seeks to mitigate burdensome Medicare regulations. Among several recommendations, the AADA suggested the streamlining of drug prior-authorization requirements.


2018 Quality Payment Program (QPP) proposed rule just released

June 20, 2017 

Late this afternoon, the Centers for Medicare and Medicaid Services’ (CMS) released its anticipated proposed rule outlining policies for the 2018 Quality Payment Program (QPP). The American Academy of Dermatology Association is pleased that CMS has listened to physician groups such as ours and incorporated several important changes to the program. Read more.


CMS announces new MACRA physician payment rule

October 14, 2016
The new MACRA rule takes effect Jan. 1, 2017, with “ramp up” time for physicians who wish to participate; participating physicians could see as much as + 4% bonus payment in 2019. Read more.


AADA voices dermatology’s concerns to CMS and congressional leaders about the proposed MACRA rule

July 27, 2016
The AADA is leading an aggressive effort to share our perspective and secure changes in the final rule that will enable dermatologists to succeed as Medicare moves from a pay-for-volume to a pay-for-value system. Read more.


Academy calls for MACRA delay, expansion of exception criteria

June 28, 2016
The comment period requesting feedback on CMS’s Medicare Access and CHIP Reauthorization (MACRA) proposed rule has come to a close. CMS received a deluge of comments from the medical community, including the AADA. In its comment letter, the AADA is requesting that CMS delay implementation of the MACRA rule from Jan. 1, 2017, to Jan. 1, 2018. The proposed rule outlines sweeping changes to Medicare payments and quality reporting — instituting two Medicare participation tracks: the Merit-Based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model program. The proposed rule stems from provisions required in the MACRA law that repealed and replaced the sustainable growth rate formula in 2015. The final rule is expected to be released in November 2016.

Specifically, the Academy requested that CMS modify the low-volume threshold — that would exempt physicians from participating in MACRA — to those whose Medicare billing charges are $75,000 or less and provide care for 750 or fewer Part B-enrolled Medicare beneficiaries, as opposed to $10,000 or 100 patients per physician. Additionally, the AADA asked CMS to shorten the reporting period from one year to three months and reduce the reporting requirement from 80 percent of MIPS eligible clinicians’ patients to 50 percent. Read more from the AADA’s comment letter. Find out more about how the proposed rule will affect your practice in the May 4 issue of Dermatology World Weekly.