Physician Fee Schedule: CMS Proposes 2018 Payment and Policy Updates


Proposed rule & Request for Information provide flexibility, support strong patient-doctor relationships

On July 13, CMS issued a proposed rule that would update Medicare payment and related policies for doctors and other clinicians who treat Medicare patients in CY 2018. The proposed rule is one of the several Medicare payment rules for CY 2018 that reflect a broader strategy to relieve regulatory burdens for providers; support the patient-doctor relationship in healthcare; and promote transparency, flexibility, and innovation in the delivery of health care services to the patients.

The Physician Fee Schedule is updated annually to include changes in payment policies, payment rates, and quality provisions for services furnished to Medicare beneficiaries. This proposed rule would provide greater potential for payment system’s modernization and seeks public comment on reducing administrative burdens for providing patient care that includes visits, care management, and tele health services. The rule takes required steps to improve the alignment of incentives and provide clinicians with a smoother transition to the new Merit-based Incentive Payment System under the Quality Payment Program.

This rule encourages fairer competition between hospitals and physician practices by promoting greater payment alignment, and it would improve the payment for office-based behavioral health services that are often the therapy and counseling services used to treat opioid addiction and other substance use disorders. In addition, the proposed rule makes additional proposals to implement the Center for Medicare and Medicaid Innovation’s Medicare Diabetes Prevention Program expanded model starting in 2018.

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