CMS Releases 2 Awaited Final Rules
CMS Finalizes Changes to Advance Innovation, Restore Focus on Patients
Changes to the Medicare Physician Fee Schedule and Quality Payment Program will shift clinicians’ time from completing unnecessary paperwork to providing innovative, high-quality patient care
The Centers for Medicare & Medicaid Services (CMS) finalized bold proposals that address provider burnout and provide clinicians immediate relief from excessive paperwork tied to outdated billing practices. The final 2019 Physician Fee Schedule (PFS) and the Quality Payment Program (QPP) rule released today also modernizes Medicare payment policies to promote access to virtual care, saving Medicare beneficiaries time and money while improving their access to high-quality services, no matter where they live. It makes changes to ease health information exchange through improved interoperability and updates QPP measures to focus on those that are most meaningful to positive outcomes. Today’s rule also updates some policies under Medicare’s accountable care organization (ACO) program that streamline quality measures to reduce burden and encourage better health outcomes, although broader reforms to Medicare’s ACO program were proposed in a separate rule. This rule is projected to save clinicians $87 million in reduced administrative costs in 2019 and $843 million over the next decade.
- View the CY 2019 Physician Fee Schedule and Quality Payment Program final rule
- View the fact sheet on the CY 2019 Physician Fee Schedule final rule
- View the fact sheet on the CY 2019 Quality Payment Program final rule
- View a chart on E&M payment amounts
CMS Finalizes Policies to Modernize and Drive Innovation in Durable Medical Equipment (DME) and End-Stage Renal Disease (ESRD) Programs
Administrator Verma: “Today’s rule finalizes market-oriented reforms by simplifying the bidding process to increase patient access to Durable Medical Equipment items and services and incentivizes the development and use of transformative and innovative dialysis therapies.”
The Centers for Medicare & Medicaid Services (CMS) finalized innovative changes to the Medicare payment rules for Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS) and the End-Stage Renal Disease (ESRD) programs. The policies aim to increase access to items and services for patients, drive competition and increase affordability.
As required by the 21st Century Cures Act, this rule also finalizes Medicare fee schedule payments for DME furnished on or after January 1, 2019 in areas of the country where competitive bidding is not in effect. Learn more.
The final rule takes significant steps forward by strengthening quality incentives, improving patient outcomes and reducing administrative burden. These changes advance CMS’ Patients Over Paperwork initiative and will allow doctors to spend less time on paperwork and more time with their patients. Based on stakeholder feedback, CMS reduced ESRD facility-related documentation burdens for the comorbidity payment adjustment so that the documentation requirements are more consistent with other payment systems. CMS also reduced the reporting burden for the ESRD Quality Incentive Program (QIP) by finalizing a more limited measure set that better aligns with the CMS Meaningful Measures Initiative.