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MGMA Washington Connection 12/21/2023

12/21/2023 8:57 AM | Rebekah Francis (Administrator)

IMPORTANT UPCOMING DATES FOR MEDICAL GROUPS

The Centers for Medicare and Medicaid Services (CMS) finalized the 2024 Medicare Physician Fee Schedule earlier this year that included a 3.37% cut the Medicare conversion factor and other important policies for medical groups. MGMA has been and will continue to advocate that Congress avert the full cut in anticipation of the new year. Unfortunately, political issues related to legislation to fund the operations of the federal government and its agencies have prevented Congress from addressing critical end-of-year Medicare policies impacting medical groups. With Congress unlikely to intervene before the end of the year, here’s a timeline of upcoming key dates:

  • Dec. 31:  3.5% APM incentive payment expires
  • Jan. 1: Cut of 3.37% to the Medicare conversion factor takes effect
  • Jan. 1: Medicare begins paying for G2211 complexity add-on code
  • Jan. 1: Qualifying APM Participant threshold increases for the 2024 performance year
  • Jan. 19: Partial federal government shutdown deadline
  • Jan. 19: 1.0 work GPCI floor expires
  • Feb. 2: Second federal government shutdown deadline
MGMA sent a letter to congressional leadership with legislative recommendations to support medical groups ahead of the new year. We will continue these advocacy efforts in 2024. Send a letter to your congressional representatives, urging them to avert the full 3.37% cut to Medicare reimbursement! 

NO SURPRISES ACT UPDATES

On Dec. 15,the No Surprises Act independent dispute resolution (IDR) portal was reopened for all disputes after previously being closed to batched disputes. The Administration released an FAQ detailing extended timelines for the submission of batched disputes and guidance for IDR entities in determining eligibility. Additionally, earlier this week a new rule was finalized setting the IDR administrative fee at $115 per dispute. The proposed rule had set the administrative fee at $150.

MGMA submitted comments on Wednesday about a separate IDR operations proposed rule. We asked for increased flexibility for batched disputes and highlighted the need to streamline the IDR process.



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