• 09/23/2021 9:15 AM | Rebekah Francis (Administrator)

    New Provider Relief funding available next week

    The U.S. Department of Health and Human Services (HHS) plans to open applications for a new round of Provider Relief Fund payments totaling $25.5 billion in distributions beginning Sept. 29, 2021. This new funding includes $8.5 billion for providers furnishing services to Medicaid, Children's Health Insurance Program (CHIP), or Medicare patients in defined rural areas, and an additional $17 billion for a Phase 4 General Distribution for providers who can document lost revenue and changes in operating expenses between July 1, 2020, and March 31, 2021. Consideration for both distributions will be determined through a single application on the Health Resources & Services Administration (HRSA) website, and HRSA will use Medicaid, CHIP, and Medicare claims data in the calculation of payments.

    As a reminder, HHS is allowing a 60-day grace period following the upcoming Sept. 30 reporting deadline for providers that received greater than $10,000 in Provider Relief funds between April 10 and June 30, 2020. HHS indicated it will not initiate any recoupment or enforcement actions for 60 days following the deadline, allowing for a period of enforcement discretion from Oct. 1 – Nov. 30, 2021. For additional information on the Provider Relief Fund, reference MGMA’s recently updated resource detailing program updates, requirements, and deadlines.

    MIPS automatic neutral payment adjustment applies to clinicians impacted by Hurricane Ida

    The Centers for Medicare & Medicaid Services announced that certain clinicians participating in the Merit-based Incentive Payment System (MIPS) will automatically receive a neutral payment adjustment for the 2021 performance year/2023 payment year due to the impact of Hurricane Ida. Clinicians located in declared disaster areas, including Louisiana, Mississippi, New York, New Jersey, and Missouri, will automatically have their performance scores across all four MIPS categories reweighted to 0% and receive a neutral payment adjustment in 2023.

    However, impacted clinicians can still choose to submit MIPS performance data. If data is submitted for at least two performance categories, the clinician will be scored and have payment adjustments applied in 2023. While the automatic reweighting policy does not apply to groups or virtual groups, these MIPS participants can apply for reweighting of one or more MIPS performance categories.

  • 09/09/2021 8:20 AM | Rebekah Francis (Administrator)

    MGMA urges HHS to delay enforcement of surprise billing requirements

    MGMA wrote to the U.S. Department of Health and Human Services (HHS) urging the agency to delay the implementation and enforcement of the surprise medical billing requirements. Beginning Jan. 1, 2022, certain providers will be prohibited from balance billing for services provided to out-of-network patients, while other clinician types will be required to provide strict notice and consent documentation before services are rendered in order to seek payment from out-of-network patients. In the letter, MGMA expressed serious concerns regarding the arbitrary and overburdensome requirements for the notice and consent process and fears that it could disrupt clinical care and practice operations. HHS will be releasing additional regulations in the coming months further implementing the ban on surprise billing.

    MGMA to Congress: Support the physician workforce

    MGMA and other leading healthcare organizations sent a letter to congressional leadership asking to include policies in the budget reconciliation legislation that would increase Medicare support for graduate medical education (GME). These additional positions would alleviate the physician shortage by gradually providing new Medicare-supported GME positions. MGMA members can participate in #MGMAAdvocacy by sending a template letter to their congressional representatives.

    Tax credits for paid leave set to expire at end of month

    Eligible medical groups have until the end of September to take advantage of the tax credits available to employers to help fund paid FMLA and sick leave for reasons related to COVID-19. The Families First Coronavirus Response Act (FFCRA) provided funds in the form of refundable tax credits to businesses with fewer than 500 employees who offer employees paid FMLA and sick leave under the Act. Although the requirement to offer paid leave under the FFCRA is no longer mandatory, the refundable tax credits are only available to businesses that offer the paid leave. To learn more about the requirements to report qualified sick and family wages, see the updated guidance from the Internal Revenue Services issued this week.

  • 08/26/2021 2:52 PM | Rebekah Francis (Administrator)

    MIPS Value Pathways demystified in member exclusive resource

    The Centers for Medicare & Medicaid Services introduced seven new Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs) for optional reporting beginning in the 2023 performance year. Check out this MGMA member exclusive resource that details the key MVP policy proposals and the proposed reporting pathways included in the CY 2022 Physician Fee Schedule. The goal of this new MIPS alternative is to provide clinicians with more meaningful reporting options through cohesive MVPs specific to physician specialties, patient populations, or clinical conditions. MIPS has caused many administrative challenges for MGMA members and has provided limited financial reward for high performance in the quality reporting program. MGMA will submit comments responding to these proposals and will provide an updated analysis highlighting key policies after the final rule is released in November.

    MGMA to HHS: Extend Provider Relief Fund reporting deadline

    In a letter to U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra, MGMA urged HHS to extend the upcoming Sept. 30 reporting deadline for the Provider Relief Fund (PRF). Per current HHS guidance, recipients of more than $10,000 in the aggregate in PRF payments received between April 10 and June 30, 2020, are required to report their use of funds through the PRF Reporting Portal by Sept. 30, 2021. However, due to the sharp increase in COVID-19 cases across the country coupled with the complex and arduous reporting requirements of the program, MGMA has heard concerns from many practices struggling to complete reporting by the deadline. In addition to requesting an extension of the reporting deadline through 2023, MGMA urged HHS to clarify its existing reporting guidance to address outstanding confusion around acceptable uses of funds and to allow PRF recipients to use payments through the end of the COVID-19 public health emergency.

    MGMA to OSHA: Exempt medical groups from new COVID-19 requirements

    MGMA submitted written comments in response to the U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) COVID-19 healthcare emergency temporary standard (ETS). The ETS places requirements, which are already in effect, on medical groups that are unable or choose not to avail themselves to relevant exemptions. In its comments, MGMA expressed concerns regarding the burdens associated with compliance and recommended that OSHA not make the ETS permanent. As MGMA continues to advocate on this issue, please send any examples of how compliance would be burdensome and/or difficult to MGMA Government Affairs.

  • 08/19/2021 8:37 AM | Rebekah Francis (Administrator)

    MGMA to CMS: Prohibit insurers from charging EFT fees

    MGMA sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure urging the Agency to use its authority under the Affordable Care Act to prohibit insurers and their payment processing vendors from imposing electronic funds transfer (EFT) fees on medical groups. A recent MGMA Stat poll indicated that 57% of medical groups report being charged fees by health insurers and payment processors to accept reimbursement through EFT direct deposit. This is a dramatic increase from the 26% who reported paying these fees only a year ago. The poll also showed that practices are typically charged 2-3% of the reimbursement amount with no clear value-add. MGMA believes EFT fees are prohibited under current law and will continue to strongly advocate against such predatory business tactics. 

    #MGMAAdvocacy opportunity: Urge Congress to prevent Medicare cuts in CY 2022!

    With more than half of the congressional session behind us, now is the time to ask Congress to support physician practices by avoiding reimbursement cuts in CY 2022. In July, CMS released the proposed rule for the CY 2022 Medicare Physician Fee Schedule. The proposed CY 2022 conversion factor (CF) is 3.75% lower than the current CF because the funds that Congress allocated to the fee schedule to mitigate the projected CY 2021 reimbursement cuts were only for CY 2021. To prevent cuts to Medicare reimbursement in CY 2022, Congress must act before the end of the year. Send a letter to your congressional representatives urging them to maintain the 3.75% increase to the conversion factor through at least CYs 2022 and 2023!

    Don’t miss it: CMS and OIG join MGMA in fraud series
    part 2

    In the second installment of the “Protect your Practice” webinar series, MGMA Government Affairs invites you to register for the second installment of the member-exclusive "Protect your Practice" webinar series on Tuesday, Aug. 31 at 1pm ET. During this session, MGMA will be joined by two of our national partners, the CMS Center for Program Integrity and the Department of Health and Human Services Office of Inspector General (OIG). Practice managers will be equipped with vital information necessary to avoid clinician-recruitment schemes from fraudsters, detect COVID-19-specific fraud and abuse, and will learn about the tools and programs the federal government uses to protect patients, medical practices, and federal healthcare programs.

  • 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.

  • 07/29/2021 10:23 AM | Rebekah Francis (Administrator)

    MGMA to Congress: Prevent Medicare cuts in 2022

    MGMA and other leading health organizations wrote to Congress urging for a legislative solution to avoid Medicare reimbursement cuts in CY 2022. Specifically, the letter calls for Congress to maintain the 3.75% increase to the Medicare conversion factor through at least CYs 2022 and 2023. Following #MGMAAdvocacy, Congress mitigated the significant cuts slated for CY 2021 by injecting $3 billion into the physician fee schedule, which resulted in a 3.75% increase to the conversion factor. MGMA will continue to work with Congress to avoid further cuts in CY 2022.

    Hundreds of stakeholders ask Congress to make telehealth flexibilities permanent

    MGMA and hundreds of other stakeholders sent a letter to congressional leadership this week highlighting shared Medicare telehealth reform priorities and voicing concern over the “telehealth cliff,” which would occur once the COVID-19 public health emergency (PHE) ends. In part, the groups asked to permanently remove geographic and originating site restrictions, remove the in-person visit requirement for mental telehealth services, and allow for audio-only reimbursement when clinically appropriate. Currently, most telehealth flexibilities are only in effect through the duration of the COVID-19 PHE. MGMA will continue to engage with Congress and the Administration to craft policies that allow medical practices to leverage telehealth to reach vulnerable patients while maintaining continuity of care.

    Tell Congress to support improvements to APMs

    Join #MGMAAdvocacy efforts to support recently reintroduced legislation that will make improvements to accountable care organizations (ACOs) and other alternative payment models (APMs) by sending a template letter to your congressional representatives. MGMA worked in tandem with the bill’s cosponsors and other national stakeholder groups to ensure that the Value in Health Care Act would be reintroduced. In addition to modifying and extending the advanced APM bonuses through 2030, the bill would make important modifications to risk adjustment rules and fix the “rural glitch” for ACOs in the Medicare Shared Savings Program. Send a letter to your representatives today!

  • 07/22/2021 8:37 AM | Rebekah Francis (Administrator)

    MGMA joined 13 other national health stakeholder groups in supporting the reintroduction of the Value in Health Care Act, a bipartisan House bill that would help to accelerate the move to value-based care models in the Medicare program. Specifically, the bill would strengthen Medicare accountable care organizations (ACOs) and other alternative payment models (APMs) by:

    • Providing a mechanism to receive advanced funding when joining or advancing in an ACO;

    • Extending the advanced APM incentive payments for an additional six years through 2030;

    • Increasing shared savings rates for ACOs in the Medicare Shared Savings Program (MSSP); and

    • Making other technical improvements to MSSP by modifying benchmarks and risk adjustment methodologies.

  • 07/22/2021 8:36 AM | Rebekah Francis (Administrator)

    Department of Health and Human Services (HHS) Secretary Xavier Becerra once again renewed the public health emergency (PHE) for COVID-19, effective July 20, 2021. The extension will continue all telehealth waivers and other flexibilities pursuant to this determination. As with previous determinations, the renewed PHE will end 90 days after its effective date on Monday, Oct. 18, 2021, unless it is extended further. The Biden Administration has indicated that it intends to continue renewing the COVID-19 PHE at least for the remainder of 2021 and to provide the healthcare community with 60 days' notice prior to allowing the PHE to lapse.

  • 07/08/2021 12:20 PM | Rebekah Francis (Administrator)

    Last week, the Department of Health and Human Services (HHS) released its first regulation implementing parts of the No Surprises Act, which was passed late last year. This interim final rule is the first of several rules in the surprise billing area that HHS plans to issue over the coming months. The law goes into effect on Jan. 1, 2022.

    For more information, review HHS’ fact sheet and the interim final rule. MGMA will release a comprehensive analysis of the rule to members in the coming weeks.

  • 07/08/2021 12:19 PM | Rebekah Francis (Administrator)

    As a reminder, the Provider Relief Fund (PRF) Reporting Portal is open for recipients to report on funds (exceeding $10,000 in aggregate) received from April 10, 2020 to June 30, 2020. Providers who received one or more payments exceeding $10,000 in the aggregate during one of the four Payment Received Periods are required to report in each applicable reporting period. Following #MGMAAdvocacy efforts, providers now have 90 days, instead of 30, to report their use of funds. For more information, see MGMA’s updated PRF resource.


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