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CMSRulemakingCMS-2016-0116

Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Pricing Data Release; Medicare Advantage and Part D Medical Low Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model (CMS-1654-P)

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American Medical Association filings
5

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American Medical Association filed 5 comments on this docket between Sep 6, 2016 and Sep 7, 2016. 304 other organizations filed here. The comment window closed 3612d ago.

What American Medical Association filed (5)

Sep 7, 2016· AMA- American Medical Association· CMS-2016-0116-5770

Filed on regulations.gov — full text not in the inline record.

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Sep 6, 2016· IL-The American Medical Association (AMA)/Specialty Society RVS Update Committee (RUC)· CMS-2016-0116-5026

Dear Acting Administrator Slavitt: The American Medical Association (AMA)/Specialty Society RVS Update Committee (RUC) appreciates the opportunity to comment on the Centers for Medicare and Medicaid Services (CMS) Notice of Proposed Rule Making (NPRM) on the revisions to Medicare payment policies under the Physician Payment Schedule for calendar year 2017, published in the July 15, 2016 Federal Register (Vol. 81, No. 136 FR, pages 46162-46476). The Proposed Rule includes a number of policy and technical modifications within the Resource-Based Relative Value Scale (RBRVS). This letter includes RUC recommendations and comments regarding the following: I.Resource-Based Practice Expense (PE) Relative Value Units (RVUs) A.PE RVU Methodology B.Practice Expense (PE) Inputs for Digital Imaging Services C.Standardization of Clinical Labor Tasks D.Clinical Labor Tasks Associated with Digital Imaging E.Equipment Recommendations for Scope Systems and Appropriate Direct PE Inputs Involved in Procedures Involving Endoscopes F.Appropriate Direct PE Inputs in the Facility Post-Service Period When Post-Operative Visits are Excluded G.Radiation Treatment Delivery, IMRT and IGRT G Codes II.Technical Corrections Needed III.Determination of Professional Liability Insurance (PLI) RVUs A.CY 2017 GPCI Update PLI premium data update B.PLI RVU Variation for Low Volume Services IV.Phase-in of Significant RVU Reductions V.CY 2017 Identification and Review of Potentially Misvalued Services A.RUC Progress in Identifying and Reviewing Potentially Misvalued Codes B.CMS Identified Potentially Misvalued Services i.000-Day Global Services that are billed with (E/M) Service with Modifier 25 ii.End-Stage Renal Disease Home Dialysis Services iii.Equipment Recommendations for Scope Systems and Appropriate Direct PE Inputs Involved in Procedures Involving Endoscopes iv.Insertion and Removal of Drug Delivery Implants v.Improving Payment Accuracy for Preventive Services: DSMT vi.Therapy Codes vii.Electromyography Studies C.CY 2017 Proposed Codes i.Biopsy Excisional ii.Insertion of Spinal Stability Distractive Device iii.Bone Biomechanical Device Insertion - Intervertebral, Interbody iv.Closed Treatment of Pelvic Ring Fracture v.Bunionectomy vi.Endotracheal Intubation vii.Flexible Laryngoscopy viii.Laryngoplasty ix.Closure of Left Atrial Appendage with Endocardial Implant x.Valvuloplasty xi.Mechanochemical (MOCA) Vein Ablation xii.Dialysis Circuit xiii.Esophageal Sphincter Augmentation xiv.Percutaneous Biliary Procedures Bundling xv.Cystourethroscopy (CPT code 52000) xvi.Biopsy of Prostate (CPT code 55700) xvii.Hysteroscopy (CPT codes 58555-58563) xviii.Epidural Injections (CPT codes 623X5, 623X6, 623X7, 623X8, 623X9, 62X10, 62X11, and 62X12) Rejected PE Only xix.Endoscopic Decompression of Spinal Cord Nerve (CPT Codes 630X1) xx.Retinal Detachment Repair (CPT codes 67101 and 67105) xxi.Fluoroscopic Guidance (CPT codes 77001, 77002, and 77003) xxii.Radiation Treatment Devices (CPT codes 77332, 77333, and 77334) xxiii.Special Radiation Treatment - CPT Code 77470 Rejected PE Only xxiv.Flow Cytometry Interpretation (CPT codes 88184, 88185, 88187, 88188, and 88189) xxv.Mammography - Computer Aided Detection Bundling (CPT codes 770X1, 770X2 and 770X3) Rejected PE Only xxvi.Closure of Paravalvular Leak (CPT codes 935X1, 935X2, and 935X3) xxv.Parent, Caregiver-Focused Health Risk Assessment (CPT Codes 961X0, 961X1) xxvi.Reflectance Confocal Microscopy (CPT Codes 96931-96936) xxvii.Prostate Biopsy, Any Method (HCPCS code G0416) D.Valuation of Specific Codes CY 2017 Proposed Codes That Were Also CY 2016 Proposed Codes i.Genitourinary Procedures (CPT codes 50606, 50705, and 50706) ii.Immunohistochemistry (CPT Codes 88341, 88342, 88344, and 88350) iii.Morphometric Analysis (CPT Codes 88364, 88365, 88367, 88368, 88369, and 88373) iv.Open and Percutaneous Transluminal Angioplasty (CPT codes 372X1, 372X2, 372X3, and 372X…

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Sep 6, 2016· IL-The American Medical Association (AMA)/Specialty Society RVS Update Committee (RUC) HCPAC Review Board· CMS-2016-0116-5025

Dear Acting Administrator Slavitt: The American Medical Association (AMA)/Specialty Society RVS Update Committee (RUC) Health Care Professionals Advisory Committee (HCPAC) Review Board appreciates the opportunity to comment on the Centers for Medicare and Medicaid Services (CMS) Notice of Proposed Rule Making (NPRM) on the revisions to Medicare payment policies under the Physician Payment Schedule for calendar year 2017, published in the July 15, 2016 Federal Register (Vol. 81, No. 1361 FR, pages 46162-46476). The Proposed Rule includes a number of policy and technical modifications within the Resource-Based Relative Value Scale (RBRVS). This attached letter includes HCPAC recommendations and comments regarding the following: I.Removal of Nail Plate (CPT code 11730) II.Evaluative Procedures for Physical Therapy and Occupational Therapy (CPT codes 97X61, 97X62, 97X63, 97X64, 97X65, 97X66, 97X67, 97X68) III.Potentially Misvalued Therapy Codes

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Abstract

This major proposed rule addresses changes to the physician fee schedule and other Medicare Part B payment policies, such as changes to the Value Modifier, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. This proposed rule also includes proposals related to the Medicare Shared Saving Program, and the release of certain pricing data from Medicare Advantage bids and medical loss ratio reports from Medicare health and drug plans. In addition, this rule proposes to expand the Medicare Diabetes Prevention Program model

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Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Pricing Data Release; Medicare Advantage and Part D Medical Low Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model (CMS-1654-P) (CMS) — American Medical Association | OpenPolis