June 27, 2019

Get out your reading glasses, it's Reg Season!

It’s summertime, which means sweltering heat and humidity in the nation’s capital, and, for those of us who like a side of regs for every meal, it means something else exciting—Reg Season!

Each summer, the Centers for Medicare & Medicaid Services (CMS) issues proposed Medicare payment regs that a have a significant impact on emergency medicine—affecting both your payment and your hospital’s payment for emergency services. We’re awaiting CMS to release the proposed regs for 2020 payments any day, but here is a preview of what to expect.

In the Medicare physician fee schedule, we could see changes to the valuation of the emergency department (ED) Evaluation and Management (E&M) codes—the most commonly billed services for emergency physicians—that would impact total Medicare reimbursement for emergency physicians by tens of millions of dollars. While this reimbursement change would apply only to Medicare payments, ACEP continues to advocate for emergency physicians as they face other reimbursement threats in the private market, such as the surprise billing legislation Congress is currently debating.

This reg also updates the Merit-based Incentive Payment System (MIPS)—a major quality reporting program for physicians under Medicare. This is particularly important because if you don’t successfully participate in the program, you could eventually see up to a 9 percent reduction to your Medicare payments. ACEP is doing everything we can to simplify the MIPS requirements to  help you avoid a penalty and potentially be eligible for a bonus.

The other reg impacting emergency medicine relates to the Outpatient Prospective Payment System (payments for hospital outpatient services). Just this week, President Trump signed an executive order to require hospitals to disclosure their negotiated rates with insurers—and we may see such a proposal in the reg. This proposal could have rippling affects across the health care system.

Once these proposed rules are released, ACEP will submit detailed responses on your behalf and keep you abreast of CMS’ response. CMS will release the final regs by November 1, 2019, and the final payment policies will go into effect 60 days later on January 1, 2020.

So, get your reading glasses ready, and stay tuned to Regs & Eggs for more updates as Reg Season kicks into high gear! 

Until next week, this is Jeffrey saying, enjoy reading regs with your eggs!

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