What ACP told Congress about Medicare Payments

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May 17, 2013
In this issue
» ACP Leader Finds Reason for Optimism About Repeal of the SGR

» Slowing of Medicare Cost Increases May Put Cost-Cutting Board on the Shelf

» Government Fine-Tunes System for Expanding Coverage to the Uninsured



About this newsletter

The ACP Advocate is an e-newsletter, edited by the College's Washington, DC governmental affairs division, created to provide you, our members, with succinct news about public policy issues affecting internal medicine and patient care. To learn more about ACP's Advocacy and to access the ACP Advocate archives, go to www.acponline.org/advocacy.

Welcome to The ACP Advocate

Today’s first story brings you information about testimony that the Chair of ACP’s Board of Regents, Dr. Charles Cutler, recently delivered to the House Ways and Means Health Subcommittee.  At the hearing on “Developing a Viable Medicare Physician Payment Policy” Dr. Cutler testified about the need to repeal the sustainable growth rate formula and move toward a payment system that rewards quality and effectiveness.  Take a look at the article for more about what Dr. Cutler and the Subcommittee had to say on the issue.

Our second story this issue is about the news that CMS has announced that they will not need to call to action the Independent Payment Advisory Board (IPAB) in 2015.  Because cost increases are projected to be within bounds, the new cost-cutting board won’t actually have to issue any recommendations for the first year it’s in effect.  Read our story for more about why.

Finally, today’s last story brings to you information about new insurance related guidance that has been issued in the past few weeks.  First, the government has released the new, simplified health insurance application.  In a related change, the Administration has also issued guidance on how brokers can help consumers navigate the health insurance system, both in finding new insurance and in applying.  Together, these two changes may be of help to your patients.  

Lastly, I look forward to seeing many of you next week in Washington for ACP’s Services annual Leadership Day.  If you aren’t able to attend, please check out our next issue for more about what your fellow ACP members had to say to Congress.

For more coverage of what's happening in Washington take a look at my award-winning blog, The ACP Advocate Blog by Bob Doherty. You can also follow me on Twitter @BobDohertyACP.

As always, please send your feedback and suggestions on this newsletter to: TheACPAdvocate@acponline.org.

Yours truly,

Bob Doherty
Senior Vice President
Governmental Affairs and Public Policy
American College of Physicians


In the news
» ACP Leader Finds Reason for Optimism About Repeal of the SGR
  Dr. Cutler's congressional testimony stresses need to replace dysfunctional Medicare payment system
 

Congress appears to be both serious and united in considering a rep... » Click to read the full article


» Slowing of Medicare Cost Increases May Put Cost-Cutting Board on the Shelf
  New report finds growth in spending at less than half the amount that would trigger required reductions
 

A controversial Medicare cost-cutting board may becoming obsolete before it ever actually renders an opinion.

That's because Medicare cost increases are projected to slow down over the next five y... » Click to read the full article


» Government Fine-Tunes System for Expanding Coverage to the Uninsured
  Changes include a shorter application form and a role for insurance agents
 

With millions of uninsured Americans poised to apply for health care coverage this fall, the federal government has made some changes that will affect that process.

For starters, it has simplified... » Click to read the full article


In focus
Tavenner Confirmed as CMS Administrator
On Wednesday, the Senate voted to confirm Marilyn Tavenner as CMS Administrator. Tavenner has been acting Administrator since December 2011, and she is the first confirmed Administrator since Mark McClellan stepped down in 2006. ACP supported her confirmation.

ACP can help you with the new transitional care codes
The ACP website has available detailed resources that can help you figure out the new CPT codes for transitional care management. Click on the link about to find a list of articles with discussion about the care components of the codes, the time constructs for the post-discharge contact with the patient, the face to face visit, and the thirty day care period.

Contact your state Medicaid office to qualify for enhanced primary care payments
Primary care and related specialty physicians will see an increase in their Medicaid payments this year to make them at least equivalent to Medicare payments. To ensure that you receive this increase, you must contact your state Medicaid office. Each state has a different timeline and procedure for physicians to fulfill an 'attestation' requirement to receive the payment increases. In some states, physicians may still be able to qualify for payments retroactive to the beginning of the year; however, you need to start the attestation process as soon as possible. Additional information about the enhanced payments is on the College's website.


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