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Seven new telemedicine codes added to Medicare physician fee schedule — ONC to release MU2 attestation numbers Tuesday — Texas telemedicine meeting focus narrowed
Politico
November 3, 2014
http://www.politico.com/morningehealth/1114/morningehealth15935.html
On Friday as trick-or-treating was getting started, CMS finalized a rule adding seven new telemedicine billing codes to the 2015 Medicare physician fee schedule, following along the lines of a rule it proposed in the summer. The new codes include those for psychotherapy, prolonged office visits, annual wellness visit and related matters. Medicare payments to telehealth originating sites will increase by 0.8 percent in 2015. Some stakeholders sought other changes, like dropping a provision that patients have to be in a rural site to receive billable telemedicine. No such luck. “We do not have authority to implement many of these revisions under the current statute,” CMS stated in the rule. “The CMS Innovation Center is responsible for developing and testing new payment and service delivery models to lower costs and improve quality for Medicare, Medicaid, and CHIP beneficiaries. As part of that authority, the CMS Innovation Center can consider potential new payment and service delivery models to test changes to Medicare’s telehealth payment policies.”
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Defects Found Before Debut of Health Insurance Site for Small Businesses
The New York Times
November 1, 2014
http://www.nytimes.com/2014/11/02/us/defects-found-before-debut-of-health-insurance-site-for-small-businesses.html?_r=0
The Obama administration has discovered a number of defects in the online marketplace that will offer health insurance to millions of small-business employees, but federal officials said the problems could probably be fixed before the website goes live on Nov. 15.  The website, for businesses with 50 or fewer employees, was created by the Affordable Care Act and was supposed to open Oct. 1, 2013, but officials could not meet that deadline. Since then, they have been trying to build the site.  Testing began last week in Delaware, Illinois, Missouri, New Jersey and Ohio, just days after federal officials gave experts in the industry a preview at a White House meeting.  Small-business owners, employees, insurers and insurance agents welcomed the website for the Small Business Health Options Program, known as the SHOP exchange, but said they had found defects that needed to be corrected.
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The Centers for Medicare and Medicaid Services Issues Ruling on 2015 Reimbursement Rates
Providence Journal
October 31, 2014
http://www.providencejournal.com/business/press-releases/20141031-the-centers-for-medicare-and-medicaid-services-issues-ruling-on-2015-reimbursement-rates.ece
Hologic, Inc. announced today that the Centers for Medicare and Medicaid Services (CMS) has released reimbursement rates for screening and diagnostic 3D mammography. The action establishes national average payment rates for the Category I Current Procedural Terminology (CPT) code for 3D screening mammography and creates a new add-on Healthcare Common Procedure Coding System (HCPCS) code for 3D diagnostic mammography.  The Medicare payment rates will go into effect January 1, 2015 and will allow providers in the U.S. to file reimbursement claims specific to screening and diagnostic 3D mammography. The CMS Medicare Physician Fee Schedule Final Rule issued today not only sets reimbursement rates for 3D mammography, but also creates a pathway for private insurers to explore broader coverage and payment options.
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Medicare releases slew of payment rules
The Hill
October 31, 2014
http://thehill.com/policy/healthcare/222511-medicare-releases-slew-of-payment-rules
The Centers for Medicare and Medicaid Services (CMS) released nearly 3,000 pages of regulations late Friday finalizing 2015 payment rates for various providers and services in the Medicare program, including physicians.  The agency also revised the workings of several smaller quality initiatives related to end-stage renal disease, ambulatory surgical centers and hospital outpatient care, and adjusted aspects of the fee schedule for durable medical equipment within Medicare.   “These rules are a part of the broader strategy driving greater value in health care," said CMS Administrator Marilyn Tavenner in a statement.  "By collaborating and building on best practices across the health care system, we can deliver the results of higher quality care and lower costs that consumers, providers, purchasers, and businesses deserve."  CMS highlighted the creation of a new payment to support chronic care management, efforts to combine and streamline payments related to a single patient's hospital care, and the expansion of the Physician Compare website.
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Medicare finalizes $60M cut to home health
The Hill
October 30, 2014
http://thehill.com/policy/healthcare/222399-medicare-finalizes-60m-cut-to-home-health
The Centers for Medicare and Medicaid Services (CMS) finalized a $60 million cut to home health agencies for 2015 in a rule released Thursday.  The cut equals 0.3 percent of Medicare payments to the industry, which provides home-based medical services to roughly 3.5 million seniors.  Groups representing home healthcare providers have lobbied to stop the cuts, arguing they will endanger care for vulnerable patients with few clinical options.  The CMS said the rule will help advance the goal of delivering better care at lower costs.  "Provisions in these rules are helping to move our health-care system to one that values quality over quantity and focuses on reforms such as measuring for better health outcomes, focusing on disease prevention, helping patients return home, helping manage and improve chronic diseases, and fostering a more-efficient and coordinated healthcare system," the agency said in a statement.  In addition to the payment cut, the rule adjusted requirements for the face-to-face encounter between physician and Medicare recipient to certify eligibility for home health services, among other provisions.
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More turmoil for House GOP lawsuit against Obama
Politico
October 29, 2014
http://www.politico.com/story/2014/10/barack-obama-john-boehner-lawsuit-112333.html
House Speaker John Boehner’s still-unfiled lawsuit against President Barack Obama for exceeding his constitutional power is in more trouble.  For the second time in two months, a major law firm has ceased work on the lawsuit, sources say.  Attorney Bill Burck and the Quinn Emanuel firm halted preparations for the proposed suit in recent weeks, according to two sources familiar with the situation. Last month, the lawyer originally hired to pursue the case, David Rivkin of Baker Hostetler, made a similar abrupt exit.  A spokesman for Boehner declined to discuss the status of the House’s relationship with Burck and Quinn Emanuel. However, spokesman Kevin Smith said Wednesday evening that House leaders are considering having the lawsuit filed by lawyers already on the House payroll.
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