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Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.

Washington Highlights

MedPAC Discusses Physician and Hospital Medicare Payment Adequacy

January 13, 2017—The Medicare Payment Advisory Commission (MedPAC) Jan. 12-13 held a meeting to discuss a range of Medicare issues, including payment adequacy of various payment systems, approaches to MACRA implementation, and Medicare Part B payment policy issues.

MedPAC revisited the payment adequacy for a range of payments systems that cover physician and other health professional services, inpatient and outpatient services, and outpatient dialysis services.

Commissioners voted unanimously in favor of the following draft recommendations:

  • Add a modifier on claims for all services provided at off-campus stand-alone emergency departments (EDs), which would allow CMS to monitor the growth of off-campus stand-alone EDs;

  • Update the inpatient and outpatient payments by the 1.85 percent specified in current law;

  • Increase payment rates for physician and other health professional services by the 0.5 percent specified in current law for 2018;

  • Eliminate the update to the payment rates for ambulatory surgical centers for 2018; and

  • Increase the outpatient dialysis base payment rate by the 1 percent update specified in current law for 2018.

MedPAC discussed various approaches to implementing MACRA, such as redesigning the Merit-based Incentive Payment System (MIPS) to eliminate or greatly reduce clinician-reported measures and focusing on clinicians with high rates of poor outcomes or extreme utilization.

Additionally, MedPAC staff discussed a package of potential reforms for Medicare Part B drug payment policy to address increases in Part B drug spending. For example, MedPAC staff proposed improving the current average sales price (ASP) system by requiring drug manufacturers to report ASP data for all Part B drugs. Commissioners will discuss reforms to Medicare Part B payment policies in the future.

MedPAC’s next meeting will be March 2-3, 2017.

Contact:

Tanvi Mehta
Physician Payment & Quality Specialist, HCA
Telephone: 202-909-2020
Email: tmehta@aamc.org

Ayeisha Cox, J.D.
Hospital Policy & Regulatory Specialist
Telephone: 202-282-0482
Email: aycox@aamc.org

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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.


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For More Information

Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806
Email: jkleinman@aamc.org