Posted July 20, 2017
The Centers for Medicare and Medicaid Services (CMS) has issued two proposed rules to update payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (PFS) and the Hospital Outpatient Prospective Payment System (OPPS). CMS will be accepting comments on these rules until September 11, 2017. The final rules are expected...
Posted June 7, 2017
The Florida standardized PA goes into effect 7/11 and payers have 6 months to transition. Florida Rule for Uniform PA Form Florida Uniform PA Form Instructions Florida Uniform PA Form
Posted May 9, 2017
BACKGROUND: FLASCO is concerned about the tremendous burden oncologists face in juggling the requirements of multiple Medicare quality improvement programs, often at the expense of time spent on patient care. The historic passage of the Medicare Access and CHIP Reauthorization Act (MACRA) would ease both the administrative and financial burdens of existing quality improvement programs. ...
Posted April 19, 2017
Mary Brogran Breast & Cervical Cancer Early Detection Program (Sec. 381.93, F.S.) Florida Department of Health Current Year State Funding (FY 2016-17) – $2,100,00 ($300,000 recurring; $1,800,000 nonrecurring) House Position (Line Item 447) – $325,000 recurring Senate Position (Line Item 447) – $350,000 recurring Request – $2,100,00 in total funding Program Description – The Mary...
Posted February 20, 2017
While health insurance utilization management (restrictions on access) procedures such as fail first/step therapy may be appropriate measures to control costs, they have also been over-utilized under the cloak of confusion surrounding health care and to the detriment of numerous patients across Florida. Contact your legislator today to let them know, ultimately, healthcare professionals, not...
Posted February 20, 2017
The Mary Brogan Breast and Cervical Cancer Early Detection Program provides lifesaving cancer screenings for medically underserved women between the ages of 50 and 64 who have incomes below 200% of the federal poverty level. For 2017, ACS CAN asks that the state fund the program at a level equal to one-half of the U.S....
Posted December 1, 2016
The House on Wednesday passed a medical innovation bill aimed at curing diseases, with the measure securing bipartisan support after months of negotiations. The legislation, known as the 21st Century Cures Act, passed 392-26. It seeks to speed up the Food and Drug Administration’s approval of new drugs while investing new money in medical research. The package...
Posted November 29, 2016
CURRENT STATUS: The House and Senate have reached a bipartisan, bicameral compromise on the 21stCentury Cures Act. The legislation includes nearly all of FLASCO’s supported provisions and is the culmination of over two years of work. The last chance for this legislation to pass during this Congress, and according to some, at all, is over...
Posted November 17, 2016
MedPAC Holds Meeting on Provider Consolidation On November 3, the Medicare Payment Advisory Committee (MedPAC) hosted a meeting on provider consolidation and its effect on the Medicare system. The discussion primarily focused on the trends towards horizontal and vertical integration among providers – essentially hospitals buying physician practices and then billing the services through their...
Posted September 22, 2016
A recent report in Health Affairs titled “Physician Consolidation: Rapid Movement from Small to Large Group Practices, 2013–15” identified an accelerating trend of physicians moving from small to large group practices, with more pronounced effects among primary care physicians. The authors used information from Medicare’s Physician Compare dataset to examine changes in the makeup of...
Posted September 22, 2016
According to a new study by the Physician Advocate Institute (PAI) and Avalere Health, the number of physician practices owned by hospitals or health systems rose 86 percent between 2012 and 2015. To reach this conclusion, Avalere examined a database of payment information maintained by SK&A, a health care consultancy, to pinpoint practice ownership...
Posted September 22, 2016
On September 8, the Medicare Payment Advisory Commission (MedPAC) met to discuss the increase in physician practices that have been purchased by hospitals or health systems, including how increases in physician practice size impact Medicare payment policy. MedPAC reviewed a private-sector database of physician information and practice characteristics, and merged it with Medicare claims to...
Posted September 22, 2016
The US Oncology Network sent a letter to Congresswoman Lynn Jenkins (R-KS) and Congressman Ron Kind (D-WI) expressing support for the Local Coverage Determination Clarification Act (H.R. 5721), legislation that changes the process Medicare Administrative Contractors (MACs) use to make local coverage decisions that can limit or deny patients’ access to care. Specifically, the bill...
Posted September 22, 2016
On September 12, The Alliance for Site Neutral Payment Reform launched a new website (www.siteneutral.org) to better educate lawmakers, industry stakeholders, and the public about the many benefits of advancing site neutral payment reforms across America’s healthcare delivery system. The website houses research and other resources on the value of payment parity across sites of...
Posted May 5, 2016
On April 27, the Centers for Medicare and Medicaid Services released much-anticipated proposed regulations that will govern implementation of the new Medicare physician payment system that replaces the sustainable growth rate (SGR) formula repealed by Congress last year. The new system offers physicians two pathways for Medicare payment beginning in 2019: the Merit-Based Incentive Payment...
Posted April 25, 2016
The next two weeks are critical to stopping the misguided Medicare experiment on cancer care! Make your voice heard – call, email, Tweet, and send Facebook messages to your elected officials asking them to Stop the Medicare Experiment on Cancer Care. COA has set up the CancerExperiment.com website for easy advocacy action. Share the website...
Posted March 17, 2016
This morning an unprecedented 313 national and state health care organizations, including FLASCO sent a letter to Congress expressing strong concern with the proposed CMS Medicare Part B Drug Payment Model. The organizations request that Congress ask CMS to withdraw the proposed rule. Click here to read the latest letter. The letter notes that the organizations believe...