CY 2021 Physician Fee Schedule Update

On December 27, 2020, the Consolidated Appropriations Act modified the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (MPFS):

  • Provided a 3.75% increase in MPFS payments for CY 2021
  • Suspended the 2% payment adjustment (sequestration) through March 31, 2021
  • Reinstated the 1.0 floor on the work Geographic Practice Cost

Recent reports indicate that House and Senate Committee leaders have apparently mutually agreed on a bipartisan arrangement for correcting or preventing surprise medical bills, although legislation has not yet been passed.

Attached is an outline of the “No Surprise Act”, which essentially deals with insured patients receiving unexpected bills for medical services.

Note

EHR Safe Harbor Permanent

The existing electronic health records items and services Safe Harbor in 42 CFR Section 1001.952(y) was amended by deleting the sunset provision, thereby making the protection permanent.

Cybersecurity Technology and Services

A new Safe Harbor for cybersecurity and technology services is added in 42 CFR Section 1001.952(jj) to facilitate improved cybersecurity. 

On December 2, 2020, the Department of Health and Human Services (HHS), the Office of Inspector General (OIG) and the Center for Medicare and Medicaid Services (CMS) will jointly publish the final regulations first proposed on October 17, 2019:

1.     AKS Safe Harbors: https://public-inspection.federalregister.gov/2020-26072.pdf
2.     Stark Exceptions:  https://public-inspection.federalregister.gov/2020-26140.pdf

The regulations will become effective January 19,

The Center for Telehealth and e-Health Law (CTeL) is presenting its virtual 2020 Fall Summit on December 1st through December 4th.  Mike Cassidy will participate in the Keynote Panel addressing the telehealth issues presented in the OIG’s September 2020 National Health Care Fraud and Opioid Takedown.

 

Michael Cassidy has been included by his peers in the Health Care Law category in The Best Lawyers in America 2021Best Lawyers is the oldest and most respected peer review publication in the legal profession, and has been compiling a list of best lawyers for 27 years.  Best Lawyers is widely regarded within

Centers for Medicare & Medicaid Services (CMS) published the new hospital outpatient and ambulatory surgical center fee schedule for 2021 on August 12, 2020 at this this link:  https://www.federalregister.gov/documents/2020/08/12/2020-17086/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment As part of the proposed revisions, CMS intends to transfer over 1,500 procedures from the “inpatient only” category, including 266 musculo-skeletal procedures as of 2021, the

On June 23, 2020, the United States District Court for the District of Columbia denied the American Hospital Association’s (AHA) summary judgment motion claiming the Trump Administration had exceeded its authority and violated the First Amendment when it issued a new rule requiring greater price transparency.

The Opinion is attached in the link below.  It