Medicare, Medicaid & CHIP

One of the leading legislative and regulatory priorities for ACEP at the moment is preventing the cuts included in the proposed Medicare physician fee schedule (PFS) for 2021, which are set to take place on January 1. This regulation from the Centers for Medicare & Medicaid Services (CMS) proposes Medicare payment rates for the coming calendar year (CY), and often serves as the basis for which many private payors set their reimbursement rates.ACEP is working closely with CMS, legislators and other physician and non-physician groups affected by the rule to push for, at the very least, a solution that holds physicians harmless from such drastic cuts–especially when many emergency physicians still face unprecedented financial hardships and instability due to the COVID-19 pandemic. Read more about the latest federal activity and ACEP’s advocacy efforts here.

Check out our Regs & Eggs blog for the latest regulatory updates

Medicare and Medicaid Regulatory Comment Letters

• ACEP Comments on Episode-Based Cost Measures Wave 4 - February 5, 2021
• ACEP Comments on MIPS Value Pathways (MVP) Town Hall Issues– January 14, 2021
• ACEP Response to Promoting Electronic Access to Health Information Proposed Rule - January 4, 2021
• ACEP Response to Request for Information on COVID-19 Regulatory Relief - December 28, 2020
• High-level Summary of 2021 Medicare PFS and MACRA/QPP Final Rule – December 1, 2020
• ACEP Comments on the 2022 Medicare Part C and D Advance Notice - November 30, 2020
• Summary of ACEP Comment Letter on 2021 Medicare PFS and MACRA/QPP Proposed Rule – October 5, 2020
  • Full ACEP Comment Letter
  • Summary of the CY 2021 PFS and QPP Proposed Rule
  • High-level Summary
• ACEP Response to Electronic Prescribing for Controlled Substances RFI - October 5, 2020
• ACEP Response to CY 2021 OPPS Proposed Rule - October 5, 2020
• ACEP Response to Medicaid Drug Utilization Proposed Rule – July 17, 2020
• ACEP Response to CMS' 2021 Inpatient Prospective Payment System Proposed Rule – July 10, 2020
• ACEP Response to Medicare Advantage and Part D Proposed Rule - April 6, 2020
• ACEP Comments on the 2021 Medicare Part C and D Advance Notice - March 6, 2020
• ACEP Response to CMS on Medicare Regulations and Scope of Practice – January 16, 2020
• ACEP Response to CMS Physician Self-Referral Proposed Rule – December 31, 2019
• ACEP Response to OIG Anti-kickback Statute Proposed Rule – December 31, 2019
• Summary of 2020 Medicare PFS and MACRA/QPP Final Rule – November 1, 2019
• ACEP Response to CMS Action Plan to Prevent Opioid Addiction and Enhance Access to MAT – October 11, 2019
• ACEP Comments on CY 2020 OPPS Proposed Rule – September 26, 2019
• Summary of ACEP Comment Letter on 2020 Medicare PFS and MACRA/QPP Proposed Rule – September 23, 2019
  • Full ACEP Comment Letter
  • Summary of Proposed Rule
  • Emergency-Medicine Specific Highlights of the Rule
• ACEP Comments on Reducing Administrative Burden Request for Information – August 12, 2019 
• ACEP Response to Hospital Co-Location with Other Hospitals Draft Guidance – July 2, 2019
• ACEP Comments on CMS' 2020 Inpatient Prospective Payment System Proposed Rule – June 24 2019
• Summary of ACEP Comment Letters on CMS and ONC Interoperability and Data Blocking Proposed Rules – May 31, 2019
  • Full ACEP Response to CMS Rule
  • Full ACEP Response to ONC Rule
• ACEP Comments on the 2020 Medicare Part C and D Advance Notice and Draft Call Letter – February 28, 2019
• ACEP Summary of CMS and ONC Proposed Rule on Health IT – February 20, 2019
• ACEP Comments on HHS' RFI on HIPAA Revisions – February 12, 2019
• ACEP Comments on Office of the National Coordinator for Health IT's Burden Reduction Draft Strategy – January 25, 2019
• ACEP Comments on CMS' Proposal on Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses – January 24, 2019
• Summary of 2019 Medicare Shared Savings/ACO Program Final Rule
• ACEP Response to Medicaid Managed Care Proposed Rule – January 10, 2019
• ACEP Comments on IPI Drug Pricing Model – December 27, 2018
• ACEP Comments on State Relief and Empowerment (i.e. Section 1332) Waivers – December 21, 2018
• ACEP Comments on CMS Proposed Rule on Reducing Provider Regulatory Burdens – November 16, 2018
• Summary of 2019 Medicare Physician Fee Schedule and MACRA/QPP Final Rule – November 5, 2018
• ACEP Comments on Proposed Rule on Medicare ACO Program – October 16, 2018
• ACEP Comments on CY 2019 OPPS Proposed Rule – September 24, 2018
• Summary of Emergency Medicine-related Provisions in CMS Proposed Rule on Reducing Provider Regulatory Burdens – September 17, 2018
• Summary of ACEP Comment Letter on 2019 Medicare PFS and MACRA/QPP Proposed Rule – September 10, 2018
  • Full ACEP Comment Letter
  • Summary of CMS Proposed Rule
• ACEP Response to CMS Request for Information Regarding the Physician Self-Referral Law – August 24, 2018
• ACEP Comments on CY 2019 Medicare Inpatient Prospective Payment System (IPPS) Proposed Rule – June 22, 2018
• ACEP Comments on the Exemptions to Methods for Assuring Access to Covered Medicaid Services Proposed Rule – May 22, 2018
• ACEP Comments on the 2019 Medicare Part C and D Advance Notice and Draft Call Letter – March 5, 2018
• ACEP Comments on 2019 Medicare Advantage and Part D Proposed Rule – January 16, 2018