CMS Updates

CMS Publishes Program Year 2022 Open Payments Data

The Centers for Medicare & Medicaid Services (CMS) published Open Payments Program Year 2022 data, along with newly submitted and updated payment records for previous program years.

Physicians can review payments attributed to them by drug and medical device companies via this link: https://openpaymentsdata.cms.gov/.

Drug and medical device companies are held accountable by law to report certain financial relationships for the purpose of the Open Payments program. Healthcare providers have a voluntary role in Open Payments and may review, affirm or if necessary, dispute data that has been reported about them. 

2024 Medicare Physician Fee Schedule (PFS) Proposed Rule Released on July 13

CMS released the 2024 PFS Proposed Rule on July 13. In addition to yet another decrease in the conversion factor used to calculate physician payments, the proposed rule includes changes to the Merit-based Incentive Payment System (MIPS), the alternative payment model (APM) participation options and requirements for 2024 and assorted other updates.

Key proposals include:

• Setting the 2024 Medicare Conversion Factor at $32.7476 -- a decrease of -3.4% over final 2023 rates;
• Extending flexibilities to permit split/shared E/M visits to be billed based on one of three components (history, exam, or medical decision making) or time through at least 2024;
• Reimbursing telehealth services furnished to patients in their homes at the typically higher, non-facility PFS rate;
• Continuing to allow direct supervision by a supervising practitioner through real-time audio and video interaction telecommunications through 2024;
• Continuing coverage and payment of telehealth services included on the Medicare Telehealth Services List through 2024;
• Pausing implementation and rescinding the Appropriate Use Criteria for Advanced Diagnostic Imaging Program regulations;
• Allowing general supervision of therapy assistants by PTs and OTs in private practice for remote therapeutic monitoring (RTM) services;
• Seeking comments on whether to allow general supervision of therapy assistants by PTs and OTs in private practice for all services;
• Increasing the performance threshold from 75 points to 82 points for all three MIPS reporting options;
• Adding five new MIPS Value Pathways related to include rehabilitative support for musculoskeletal care;
• Making numerous changes to the Medicare Shared Savings Program (MSSP) such as revising the MSSP quality performance standard, modifying the program’s benchmarking methodology, and determining beneficiary assignment under the MSSP; and,
• Ending the 3.5% APM Incentive Payment after the 2023 performance year/2025 payment year, and transitioning to a Qualifying APM Conversion Factor in the 2024 performance year/2026 payment year.

CMS will receive comments on the 2024 PFS Proposed Rule through September 11, 2024: https://www.regulations.gov/. The final rule is expected by November 1, 2024.

Click here to view the Proposed PFS Fact Sheet

Click here to view the Proposed Rule

Participate in a Survey

On behalf on the MUSC Department of Orthopaedics - Spine team, we are asking for your participation in a short survey regarding surgeon attitudes and practices on spinal cord stimulators and their effect on operative management. Chronic pain presents significant challenges for both patients and clinicians, and studying provider practices and attitudes towards spinal cord stimulation use can enable healthcare professionals to share their expertise and best practices, foster innovation, and enhance patient care. 

We would greatly appreciate your time to complete the survey. It should take no longer than 3-5 minutes. We greatly appreciate your time! 

Accredited Courses to Meet DEA Training Requirement

The U.S. Department of Justice's Drug Enforcement Administration (DEA) has a new one-time, eight-hour training requirement for all registered practitioners on the treatment and management of patients with opioid or other substance use disorders. The Doctors Company is offering on-demand courses that will help meet this requirement.



Click here to begin the courses.

OCR Issues Cybersecurity Reminders

The HHS Office for Civil Rights (OCR) is reminding organizations about the importance of strong authentication practices. Weak or non-existent authentication processes leave your digital door open to intrusion by malicious actors and increase the likelihood of potential compromise of sensitive information – including electronic protected health information (ePHI). Click here to read more.

Nearly 60% of Healthcare Providers Experienced a Data Breach Since 2021

Nearly 60% of healthcare providers experienced one or more security breaches and 45% experienced a data breach from an outside source or distributed denial-of-service since 2021, according to a new report from SOTI. To learn more about the report and its major findings, click here.

DOJ Enforcement Action for $2.5B in Health Care Fraud

The enforcement action included charges against 11 defendants in connection with the submission of over $2 billion in fraudulent claims resulting from telemedicine schemes. In a case involving the alleged organizers of one of the largest health care fraud schemes ever prosecuted, an indictment in the Southern District of Florida alleges that the chief executive officer (CEO), former CEO, and Vice President of Business Development of purported software and services companies conspired to generate and sell templated doctors’ orders for orthotic braces and pain creams in exchange for kickbacks and bribes. The conspiracy allegedly resulted in the submission of $1.9 billion in false and fraudulent claims to Medicare and other government insurers for orthotic braces, prescription skin creams, and other items that were medically unnecessary and ineligible for Medicare reimbursement. Click here to read more.

Nursing Groups Denounce AMA's Effort to Regulate Advanced Practice RNs

Nursing groups are denouncing the American Medical Association's recent policy amendment calling for advanced practice RNs (APRNs) to be licensed and regulated jointly by the state medical and nursing boards.

The National Council of State Boards of Nursing (NCSBN) "strongly opposes" the recommendation, given that U.S. nursing regulatory bodies (NRBs) have regulated the practice of nursing for more than 100 years, the NCSBN noted in a statement. To read more, click here.

Give and Take

by Adam Grant

In Give and Take, organizational psychologist, beloved Wharton professor and best-selling author Adam Grant summarizes extensive research suggesting most people at work operate as takers, matchers or givers.

“Whereas takers strive to get as much as possible from others and matchers aim to trade evenly, givers are the rare breed of people who contribute to others without expecting anything in return.”

While passion, hard work and talent remain key ingredients to professional success, they are not enough. The manner in which we interact with others is a key determinant of enduring success. Avoid the temptation to dismiss giving as a viable professional strategy and challenge yourself to consider Grant’s data and conclusions derived from it. You can then decide to take it, leave it or give it a try. 

Have a Book that was Meaningful to your Professional Journey?

Please consider sharing a short paragraph about lessons learned from a book that has shaped you as a leader. Send your summary to Sarah Thompson.