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MGMA Washington Connection - 12/10/20

12/14/2020 11:46 AM | Rebekah Francis (Administrator)

Tell Congress to support medical groups in year-end legislation!

As Congress continues to negotiate an end-of-year legislative package, it is essential for lawmakers to hear from medical group practices on two issues that could impact the financial viability of your organization. Help #MGMAAdvocacy by sending your congressional representatives letters urging them to:

  • Prevent Medicare cuts: Due to budget neutrality requirements, the finalized payment increases to office/outpatient E/M services and other payment policies will result in a 10.2% reduction to the 2021 Medicare physician fee schedule conversion factor. While MGMA is supportive of streamlined documentation policies and payment increases to office visits, we strongly oppose the resulting payment cuts to many specialties. Urge Congress to pass legislation that would prevent Medicare reimbursement cuts before they begin.

Suspend Medicare sequestration: The CARES Act, signed into law in March, offered much-needed relief to medical groups by placing a temporary moratorium on the 2% Medicare sequestration cut. Unfortunately, the Medicare sequestration cuts are scheduled to return Jan. 1, 2021. Urge Congress to pass legislation before the end of the year to delay reinstatement of the MGMA-opposed sequestration cuts until the end of the COVID-19 public health emergency.

Advanced APMs: Check for missing 2018 payments by Dec. 13 

Group practices that participated in an advanced alternative payment model (APM) in 2018 and earned the 5% bonus payment should review CMS' list of qualifying participants (QPs) who remain unpaid and follow instructions on how to claim payments if their QPs are listed. More information can be found in this zip file. CMS distributed 2018 APM incentive payments in September, but the agency indicated there are many QPs it has been unable to locate in order to issue the incentive payments.

Following MGMA advocacy, CMS extended the deadline to provide updated information from Nov. 13 to Dec. 13. While we urged the agency to eliminate the deadline altogether and pursue more extensive outreach, we are pleased the agency is giving unpaid clinicians more time to claim the payments they earned. Even group practices that have already received an APM bonus payment should check the file for their clinicians' names, as the payments received earlier may have omitted certain clinicians' payments.


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