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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.


Stopgap funding bill includes health care wins

February 9, 2018

The AADA is pleased with a bill passed by Congress today that, in addition to funding the government through March 23, repeals the Independent Payment Advisory Board (IPAB) and stops an effort to extend the misvalued codes policy, two top AADA legislative priorities.

These successes culminate efforts by hundreds of AADA members who lobbied their members of Congress at annual AADA Legislative Conferences, in response to grassroots calls to action, and in comment letters to Congressional leaders.

IPAB created the potential to impose indiscriminate new payment cuts on physicians, while the misvalued codes policy required CMS to cut the Medicare Fee Schedule by .5% by correcting “misvalued” codes or through across-the-board cuts.

Additionally the bill includes AADA-supported provisions that:

  • Relieve MACRA burdens through adjustments to MIPS, including eliminating mandates that EHR standards become more stringent each year.
  • Expand access to telehealth services within Medicare Advantage beginning in 2020.
  • Fund Community Health Centers for two years. 

While the Academy applauds the above positive actions, concerns remain about provisions that lower automatic updates to the 2019 Medicare Physician Fee Schedule from .5% to .25% and extend mandatory Medicare Sequestration cuts another year. The bill also reduces funding to the Prevention and Public Health Fund, which covers skin cancer prevention, among other priorities. The Academy will continue longstanding advocacy efforts supporting fair and reasonable Medicare payment and adequate funding for prevention and public health awareness.

On February 7, the AADA provided its comments regarding provisions in the legislation. Look for additional updates on how these changes will affect dermatologists in upcoming issues of Dermatology World Weekly and on AAD.org.​


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.


AADA, coalition letter on preserving patient access to Part B treatments

December 6, 2017

Several medical societies including the American Academy of Dermatology Association sent a letter to Congressional leaders urging them to preserve patients' access to critical Part B drug treatments by preventing the Centers for Medicare and Medicaid Services (CMS) from applying Merit-based Incentive Payment System (MIPS) score adjustments to Medicare Part B payments. In its 2018 Quality Payment Program (QPP) final rule, CMS announced it will be imposing these payment adjustments to Part B drug payments in addition to physicians' services under the Medicare fee schedule.  The letter requests a technical correction to curtail this policy and preserve patient access to the services and treatments they need.  To read the letter, click here.


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.


Academy comments on proposed ’18 Fee Schedule

September 7, 2017

The AADA has submitted to the Centers for Medicare & Medicaid Services (CMS) its comments on the proposed 2018 Medicare Physician Fee Schedule, which was released in July.  In its comments letter, the AADA requests a number of technical changes to the proposed valuation of specific codes, recommends that CMS accept RVU Update Committee (RUC)-recommended times and RVUs, and expresses concern regarding prior authorization requirements, drug pricing, and modifier 25 payment reduction policies.  The AADA also indicates its full support of CMS’ proposal to reduce the Physician Quality Reporting System (PQRS) requirements of 6 measures down from the current program policy of 9 measures.  In addition, the AADA appreciates that CMS proposed to accept our recommendation to reduce the maximum Value Modifier penalty in 2018 from 4% to 2%.

Click here to read AADA comments on the proposed rule.  The final 2018 Fee Schedule rule is expected to be released in November. 


CMS releases proposed 2018 Medicare Fee Schedule

July 13, 2017

The Centers for Medicare and Medicaid Services (CMS) today released the proposed 2018 Medicare Fee Schedule. Read the AADA breaking news alert with more information. AADA staff continues to analyze the rule, will be publishing other analyses, and plans to submit comments to CMS by September 11, 2017.


Regulatory relief for physicians recommended by lawmakers to HHS Secretary Price

May 24, 2017 

With the support of the AADA and other organizations that are members of the Physicians' Regulatory Relief Coalition, a bipartisan group of U.S. Representatives sent a letter to Health and Human Services (HHS) Secretary Tom Price, MD, expressing their support for regulatory relief for physicians.  This letter was sent before the release of the Medicare physician fee schedule, which is set to take place this summer. 

In their letter the lawmakers recommend that HHS consider: reducing the potential penalties provided for under the Value-Based Payment Modifier, adopting broader Electronic Heath Record (EHR) “Meaningful Use” (MU) Hardship Exemptions, and easing the burdens of the Physician Quality Reporting System (PQRS).  Click here to read the letter.


AADA sends advocacy positions and priorities to Senate Finance Chairman

May 23, 2017

In response to a request from Senator Orrin Hatch (R-UT), Chair of the Senate Finance Committee, for comments on the American Health Care Act (AHCA) and the Affordable Care Act (ACA), the AADA has sent a letter highlighting the Academy's advocacy positions and priorities.  This letter also includes a copy of the AADA's Health System Reform Principles.  Click here to read the letter.


2017 Medicare Physician Fee Schedule released

November 2, 2016
CMS released the 2017 Medicare Physician Fee Schedule Final Rule Nov. 2, 2016. While providing overall a 0% increase in dermatology payments, the fee schedule also contains important developments for dermatology, such as a modified reporting burden on global periods. Learn more about the final fee schedule.


AAD comments on 2017 Fee Schedule

August 30, 2016
The Academy submitted comments to CMS on the proposed 2017 Medicare Fee Schedule. Read the letter.