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Dec. 6, 2015                                                                                             Vol. 4, No. 65





TMA provides comments to CMS regarding the implementation of MIPS


In a recent letter to the Centers for Medicare & Medicaid Services (CMS), TMA President, Tom Garcia, MD, cites TMA's concerns that the myriad of compliance, documentation and reporting requirements that will be implemented in the future Medicare system will have little, if any impact on improving health care quality or increasing efficiency. 


TMA's letter was submitted in response to a CMS request for information regarding the implementation of the Merit-Based Incentive Payment System or MIPS, promotion of alternative payment models and incentive payments for participation in eligible alternative payment models as published in the Oct. 1, 2015 Federal Register.  


To read the full text of TMA's letter, along with supporting documents, click here.



For local discussion on this and other practice management and advocacy topics, consider joining the BCMS Legislative and Socioeconomics Committee by contacting Mary Nava.





File by Dec. 16 to avoid Medicare pay cut of 2-4 percent


Practices that may have thought they were safe from Medicare payment penalties next year could be in for an unpleasant surprise if they don't take action now.

Problems with how the Centers for Medicare & Medicaid Services (CMS) has been collecting and analyzing data related to the Physician Quality Reporting System (PQRS) and the value-based payment modifier are leading to inappropriate penalties of 2-4 percent of Medicare payments for thousands of physicians.

How to avoid the penalty: File an informal review request with CMS before midnight Eastern time Dec. 16. CMS has said it will verify incentive eligibility and payment adjustment determinations for practices that file such a request. 

Additional information about the process and contact information for questions is available in CMS' informal review fact sheet

Note: CMS has said the informal review system will be down Dec. 3-7 and unable to accept requests during that time.

Think it shouldn't be this way? We agree. That's why the American Medical Association (AMA) is pressing CMS to rectify the impossible situation in which it has placed physicians.





Addressing Child Abuse and Neglect in 2016


The Public Health and Patient Advocacy Committee at BCMS is looking for doctors who would like to volunteer their time to support efforts to better address issues of child abuse and child neglect in Bexar and the surrounding counties. 


This adjunct committee would focus on researching the issue, collecting data, looking at what is already being done locally, what is being done elsewhere that has been effective and then making recommendations to the full committee. 


The PH&PA Committee meets on the first Wednesday of every odd month at the BCMS offices. For more information or to volunteer to participate please contact committee liaison Mike Thomas at 210-582-6399.








Hospitals say CMS payment rule could shut down their labs


Summary of article from Modern Healthcare:

If the Centers for Medicare and Medicaid Services (CMS) goes forward with a new payment proposal for clinical diagnostic tests it could lead to labs closing and beneficiaries losing access to tests, healthcare providers warn.

The new proposal would pay Medicare rates the same as private insurance rates for clinical diagnostic tests.


The new laboratory payment rates would result in a $360 million loss for laboratories in 2017 and a potential Medicare savings of more than $5.14 billion.

Thomas Nickels, executive vice president at AHA said in a comment letter that reduced payments would lead to lab closures and lack of patient access. 

Dr. Charles Hill, president of the Association for Molecular Pathology, an international medical association representing over 2,300 physicians involved with laboratory testing, spoke out against the proposal.


"The addition of complicated reporting requirements, in conjunction with the statutory penalty for failure or incorrect reporting, would potentially discourage hospitals from providing molecular pathology testing and other reportable testing in-house, resulting in a substantial decrease in access to testing for Medicare beneficiaries and a decrease in patient choice over critical healthcare decisions." 

The agency is expected to finalize the rule by year's end based on a timeline outlined in the rule.





Bexar County Medical Society

6243 I-10 West, Suite 600 

San Antonio, TX 78201







About The Weekly Dose

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