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MGMA to Congress: Prevent Medicare cuts in 2022

MGMA and other leading health organizations wrote to Congress urging for a legislative solution to avoid Medicare reimbursement cuts in CY 2022. Specifically, the letter calls for Congress to maintain the 3.75% increase to the Medicare conversion factor through at least CYs 2022 and 2023. Following #MGMAAdvocacy, Congress mitigated the significant cuts slated for CY 2021 by injecting $3 billion into the physician fee schedule, which resulted in a 3.75% increase to the conversion factor. MGMA will continue to work with Congress to avoid further cuts in CY 2022.

Hundreds of stakeholders ask Congress to make telehealth flexibilities permanent

MGMA and hundreds of other stakeholders sent a letter to congressional leadership this week highlighting shared Medicare telehealth reform priorities and voicing concern over the “telehealth cliff,” which would occur once the COVID-19 public health emergency (PHE) ends. In part, the groups asked to permanently remove geographic and originating site restrictions, remove the in-person visit requirement for mental telehealth services, and allow for audio-only reimbursement when clinically appropriate. Currently, most telehealth flexibilities are only in effect through the duration of the COVID-19 PHE. MGMA will continue to engage with Congress and the Administration to craft policies that allow medical practices to leverage telehealth to reach vulnerable patients while maintaining continuity of care.

Tell Congress to support improvements to APMs

Join #MGMAAdvocacy efforts to support recently reintroduced legislation that will make improvements to accountable care organizations (ACOs) and other alternative payment models (APMs) by sending a template letter to your congressional representatives. MGMA worked in tandem with the bill’s cosponsors and other national stakeholder groups to ensure that the Value in Health Care Act would be reintroduced. In addition to modifying and extending the advanced APM bonuses through 2030, the bill would make important modifications to risk adjustment rules and fix the “rural glitch” for ACOs in the Medicare Shared Savings Program. Send a letter to your representatives today!

MGMA joined 13 other national health stakeholder groups in supporting the reintroduction of the Value in Health Care Act, a bipartisan House bill that would help to accelerate the move to value-based care models in the Medicare program. Specifically, the bill would strengthen Medicare accountable care organizations (ACOs) and other alternative payment models (APMs) by:

• Providing a mechanism to receive advanced funding when joining or advancing in an ACO;

• Extending the advanced APM incentive payments for an additional six years through 2030;

• Increasing shared savings rates for ACOs in the Medicare Shared Savings Program (MSSP); and

• Making other technical improvements to MSSP by modifying benchmarks and risk adjustment methodologies.

Department of Health and Human Services (HHS) Secretary Xavier Becerra once again renewed the public health emergency (PHE) for COVID-19, effective July 20, 2021. The extension will continue all telehealth waivers and other flexibilities pursuant to this determination. As with previous determinations, the renewed PHE will end 90 days after its effective date on Monday, Oct. 18, 2021, unless it is extended further. The Biden Administration has indicated that it intends to continue renewing the COVID-19 PHE at least for the remainder of 2021 and to provide the healthcare community with 60 days' notice prior to allowing the PHE to lapse.

Last week, the Department of Health and Human Services (HHS) released its first regulation implementing parts of the No Surprises Act, which was passed late last year. This interim final rule is the first of several rules in the surprise billing area that HHS plans to issue over the coming months. The law goes into effect on Jan. 1, 2022.

For more information, review HHS’ fact sheet and the interim final rule. MGMA will release a comprehensive analysis of the rule to members in the coming weeks.

As a reminder, the Provider Relief Fund (PRF) Reporting Portal is open for recipients to report on funds (exceeding $10,000 in aggregate) received from April 10, 2020 to June 30, 2020. Providers who received one or more payments exceeding $10,000 in the aggregate during one of the four Payment Received Periods are required to report in each applicable reporting period. Following #MGMAAdvocacy efforts, providers now have 90 days, instead of 30, to report their use of funds. For more information, see MGMA’s updated PRF resource.

This afternoon, the Department of Health and Human Services (HHS) released its first regulation implementing provisions of the No Surprises Act. On Dec. 27, 2020, the No Surprises Act was signed into law as part of the Consolidated Appropriations Act of 2021, with the goal of protecting patients from receiving surprise medical bills. The law, in part, allows providers and insurers to use an independent dispute resolution (IDR) process when disagreements arise over reimbursement. MGMA was successful in advocating that Congress forbid arbitrators from considering public payer reimbursement rates during the IDR process. The law goes into effect on Jan. 1, 2022.

For more information, review HHS’ fact sheet and the interim final rule. MGMA will release a comprehensive analysis of the rule to members in the coming weeks.

Earlier this week, MGMA sent a letter to the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) asking it to rescind or delay its emergency temporary standard (ETS) aimed at protecting workers facing the highest coronavirus hazards — those working in healthcare settings where suspected or confirmed coronavirus patients are treated. MGMA believes the ETS was issued much too late and will disrupt the ongoing efforts of medical groups to balance the needs of patients against the imperative to protect employees. MGMA hopes that OSHA will rescind the ETS, or at a minimum, delay its effective date until stakeholders have adequate opportunity to provide input on the standard.

The Centers for Medicare & Medicaid Services (CMS) announced that 2021 alternative payment model (APM) incentive payment details are now available on the QPP website. After logging in, organizations will be able to see the amount paid for eligible clinicians that achieved qualifying participant (QP) status during the 2019 performance year. Clinicians who were QPs in an advanced APM entity in 2019 should begin receiving a 5% APM incentive payment this month.

No action is required to receive these payments unless CMS is unable to verify a clinician's Medicare billing information. If payment is not received, check the CMS public notice, which indicates the names of clinicians whose billing information could not be verified. Such clinicians will need to verify their Medicare billing information by November 1, 2021, in order to receive their APM incentive payment. For additional information, download CMS' 2021 Learning Resources for QP Status and APM Incentive Payment zip file.

While COVID-19 cases have slowed considerably in Tennessee, the work is far from over. With fewer than 50% of Tennesseans having received at least one dose of a COVID-19 vaccine, the unknown impact of the upcoming fall respiratory season, increasing variant strains, and booster vaccines likely on the horizon, the TN Department of Health is asking Tennessee’s health care providers to assist with vaccinating Tennesseans at every opportunity. If your practice is already administering COVID-19 vaccines, thank you! If your practice is not, please consider signing up to do so! Our team will walk you through the process. Patients trust you, and your strong recommendation to get vaccinated is critical to protecting Tennesseans from the next surge.  Please visit COVID-19 Vaccine Information for Healthcare Providers (tn.gov) For more information on becoming a pandemic vaccine provider, or email vaccine.onboarding@tn.gov to get started in the process.  Please help us protect the people of Tennessee!

MGMA joined 12 leading healthcare organizations in supporting the Accountable Care in Rural America Act, a recently reintroduced bill that addresses the way financial targets are set for Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program. This piece of legislation would improve the accuracy and fairness in evaluating ACOs by fixing the "rural glitch," a flaw in the benchmarking methodology that disproportionately affects rural ACOs. We hope Congress acts to correct this flaw and levels the playing field for all ACOs to achieve savings when they improve quality and reduce costs.