Reimbursement: CMS Remains Laser-Focused on Quality and Coordination, Proposals Suggest

Why This Topic Matters

These proposals could affect Medicare reporting, reimbursement workflows, telehealth coverage, outpatient payment treatment, and documentation expectations. Readers who work with Medicare billing or practice operations can use the article to understand where policy changes may be headed and what areas may require attention.

Article Sections

1. CMS 2018 Medicare Physician Fee Schedule proposals

   Overview of the proposed Medicare Physician Fee Schedule updates for CY 2018 and the broader themes of quality, reporting, and administrative simplification.

2. Medicare Diabetes Prevention Program

   Discussion of proposed expansion and operational considerations for the Medicare Diabetes Prevention Program and related supplier participation issues.

3. Telehealth expansion

   Coverage expansion proposals for telehealth services and related billing process changes affecting certain services.

4. OPPS rate reduction

   Proposed payment changes affecting non-excepted off-campus departments and their relationship to outpatient prospective payment policy.

5. E/M changes

   Proposed updates to evaluation and management documentation requirements and broader concerns about code guidance and clinical workflow.

6. MACRA additions

   Quality payment program transition issues, including proposed changes tied to MIPS, APMs, reporting measures, and related modifiers.

7. Feedback

   Summary of CMS’s request for public input on the proposed policies and the role of comments in the rulemaking process.