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MGMA Washington Connection 08/12/2021

08/12/2021 7:55 AM | Rebekah Francis (Administrator)

Biden administration proposes to rescind MFN model

After pushback from MGMA and other industry stakeholders, the U.S. Department of Heath and Human Services (HHS) proposed to withdraw the Trump administration’s Most Favored Nation (MFN) model. The mandatory model would have tied reimbursement for Medicare Part B drugs to prices paid in other countries, resulting in lower reimbursement rates to physician practices. The model and corresponding rule was finalized in late 2020, but blocked by federal judges and subsequently frozen by President Biden. Although HHS proposes to rescind the MFN model, it is clear that the Biden administration and Congress will look for other avenues to curb rising drug prices.

Support advocacy to remove patient cost sharing for CCM services

Join #MGMAAdvocay efforts by sending a template letter to your congressional representative urging for support of the recently introduced legislation to improve patient access to chronic care management (CCM) services. MGMA sent a letter alongside numerous other national stakeholder groups supporting the reintroduction of the Seniors’ Chronic Care Management Improvement Act of 2021. This important legislation would remove the 20% patient co-insurance amount for CCM services, reducing administrative burdens and enabling group practices to utilize these services to better manage the chronic conditions of their patients. Send a letter to your representative today!

Can't miss resource: 2022 Medicare Physician Fee Schedule analysis

The CY 2022 Physician Fee Schedule proposed rule includes many complex policy proposals, and the MGMA member exclusive key takeaway analysis highlights the top policy proposals impacting group practices. This can’t miss resource will help you and your practice understand and anticipate proposed changes to physician payment in CY 2022. The proposed rule includes policy proposals that would update the annual conversion factor, make changes to telehealth covered services, modify the definition of an E/M split (or shared) visit, and introduce the Merit-based Incentive Payment System Value Pathways as a voluntary reporting option for the 2023 performance year. This resource is only the first opportunity to engage with MGMA to understand the changes to physician payment in 2022, so be on the lookout for other key insights and resources from MGMA.


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