Efforts to improve key proposed federal regulations and enact legislation modernizing physician self-referral laws (Stark Law) and to reform the U.S. Preventive Services Task Force (USPSTF) were outlined by LUGPA Health Policy Chair Deepak A. Kapoor, MD, during a health policy briefing at the LUGPA annual meeting in Chicago.
Dr. Kapoor outlined LUGPA’s efforts to influence the final rules involving the Quality Payment Program established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the Medicare physician fee schedule for 2018, and the Hospital Outpatient Prospective Payment System and Ambulatory Surgery Center Payment System.
Most “in flux,” Dr. Kapoor said, is the proposed MACRA regulation, noting that he has met with officials at the Centers for Medicare & Medicaid Services (CMS) regarding proposals supported by LUGPA to ease requirements in reporting for physicians who will be part of the Merit-based Incentive Payment System (MIPS). LUGPA has submitted comments containing several proposed revisions to the draft regulation, which is expected to be finalized soon, he said.
Dr. Kapoor said many urologists will be disappointed in the bonuses for which they will be eligible by investing in “infrastructure” designed to improve efficiency. Those bonuses will be financed by penalties imposed on physicians who do not comply and a large percentage of providers are being exempted—thus reducing the funding available for the bonuses.
In its comments to CMS, LUGPA urged the agency to “create a more level playing field under the MIPS by halting the continued erosion of the pool of MIPS-eligible clinicians so that urologists and other physician specialists will be able to succeed under the program.”
“We don’t expect a lot of major changes, but we have to keep an eye on the final rule,” said Dr. Kapoor.
In its comments to CMS, LUGPA asked the agency to “carry out Congress’ intent” of eliminating the Medicare payment incentive for hospitals to purchase physician offices and convert them into off-campus provider-based departments (PBDs).
Dr. Kapoor said LUGPA would like CMS to modify payment policy applicable to hospital off-campus PBDs that are permitted to receive payments for items and services under the Hospital Outpatient Payment System.
LUGPA also said CMS should ensure that specialists are allowed to care for patients through multiple accountable care organizations (ACOs), and it called for elimination of a proposed reimbursement cut for a technical component of prostate biopsy services.