Advocacy & Policy Updates

PCC Supports Proposed 2021 Medicare Physician Fee Schedule

October 5, 2020

The PCC sent a letter today to the Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma to voice its strong support of CMS’s proposed Medicare Physician Fee Schedule (MPFS) for calendar year 2021. The letter stated that the "proposed MPFS moves toward fundamentally correcting the longstanding undervaluation of primary care services by retaining increases to office-based Evaluation & Management (E/M) services finalized in the CY2020 MPFS and set to take effect this January." The PCC also stated that the increased investment was essential—though not sufficient—to achieving high-performing primary care and that "it must also be accompanied by rapid movement toward global payments that are prospective and comprehensive."

Read the full letter.

Pediatric care down sharply due to pandemic

September 30, 2020

Last week, the Centers for Medicare and Medicaid Services released Medicaid and CHIP data showing a “drastic decline” in vaccinations and other routine and preventative care for children. Compared to the same period last year, 2020 data shows 22% fewer vaccinations for children up to age two; 44% fewer child screening services; and 69% fewer dental services. These declines were seen despite increased use of telehealth, leading the agency to issue an “urgent call to action” to ensure accessible services for all children and avoid long-term health consequences.

Watch the recording of the PCC’s most recent monthly webinar, which addressed this topic, among others.

CMS loan recoupment delayed

September 30, 2020

In August, CMS was scheduled to begin recouping loans made to healthcare providers through its Accelerated and Advance Payment (AAP) Programs; however, Administrator Seema Verma had paused the loan payback while waiting on potential congressional action. That action came this week through the continuing resolution that delays the recoupment start date from the original timeframe (120 days after the loan was made) to one year after the loan was made. The bill also includes an extended repayment timeline and a reduced interest rate of 4%, down from 9.6%. Separately, CMS has clarified that financial support through the Provider Relief Fund and forgiven small-business loans such as PPP will not count against providers in future Medicare payment calculations.

The latest on telehealth

September 30, 2020

In early August, President Trump signed an executive order that directs CMS to make permanent some of the 135 telehealth services that had temporarily been added during the public health emergency. At the same time, healthcare payers and other stakeholders continue to assess the impact of telehealth on safety, quality, and costs. This includes the Taskforce on Telehealth Policy, convened in June by NCQA, Alliance for Connected Care, and the American Telemedicine Association. The taskforce’s report, issued Sept. 15, offers recommendations for future telehealth policy based on telehealth utilization during the pandemic and input from hundreds of stakeholders through townhall convenings and written comments. Academics and think tanks also continue to explore how to best integrate and pay for telehealth, including in this Commonwealth Issue Brief: “Telemedicine: What Should the Post-Pandemic Regulatory and Payment Landscape Look Like?” and in this Health Affairs Blog post: “Five Ways—Beyond Current Policy—To Truly Integrate Telehealth Into Primary Care Practices.” And AHRQ announced that next month it plans to release a new patient experience survey to assess satisfaction with telehealth visits.

Register for the PCC’s next monthly webinar—Making the Call on the Best Use of Telehealth in Primary Care—on Oct. 21 from 4:00 to 05:00 p.m. EDT.

Proposed 2021 Medicare Physician Fee Schedule

September 30, 2020

Last month, CMS released its calendar year 2021 Medicare Physician Fee Schedule (MPFS) for comment. The proposed rule includes a budget-neutrality adjustment to offset, in part, the increased rates for office/outpatient Evaluation and Management services set to take effect this January. The proposed adjustment reduces the Medicare conversion factor by about 10% from $36.09 in 2020 to $32.26. Primary care clinicians will see increases between 8% and 13%. Other MPFS changes include adjustments to reporting and measures for the Medicare Shared Savings Program and MIPS. The PCC is working with its Policy Committee to submit a comment letter on the proposed rule by CMS’s Oct. 5 deadline.

New report on capturing non-fee-for-service spending to measure investment in primary care

September 30, 2020

Rand Corp. has issued a new report, funded by the Milbank Memorial Fund, that explores how to capture non-fee-for-service spending when measuring levels of primary care investment. Health care is moving away from traditional claims with greater adoption of alternative payment models, although the pace is slow. The report identifies key policy decisions that must be answered in order to capture these non-FFS investments—such as risk sharing, provider incentives, HIT, and workforce expenditures—to more accurately measure and compare levels of primary care spending. This topic will be explored further at the PCC Executive Member and State Policymaker Workshop on Dec. 2.

PCC Endorses Bill That Would Support Telehealth by Expanding Broadband Coverage

September 14, 2020

The PCC is among many national organizations throwing their support behind the Broadband Reform and Investment to Drive Growth in the Economy (BRIDGE) Act of 2020, introduced this summer by U.S. Senator Michael Bennet (D-Colo.), who said the bill will deploy affordable, “future-proof” broadband networks nationwide. Senator Angus King (I-Maine) also supports the legislation, along with dozens of national and state-level elected officials and organizations. 

“The coronavirus pandemic has brought into focus a 21st century reality: access to high-speed, affordable broadband is critical infrastructure that helps Americans across the nation operate their businesses, pursue their education, access telehealth, and interact with their communities,” said King. “Unfortunately, too many rural communities don’t have access to this vital tool, leaving them at risk of being left behind.”

As the regular surveys of primary care clinicians and patients conducted by the PCC and the Larry A. Green Center since March have shown, primary care pivoted to telehealth very quickly when stay-at-home orders were put into place and has depended on it as patients seek care but are not able to visit their primary care practices in person. Telehealth services are dependent on reliable internet networks, and networks moving to unserved and underserved areas will enable primary care to address health inequities, which sometimes follow the technological divides among population groups.

"As the pandemic keeps millions of families at home, it has never been more urgent to extend the benefits of affordable, high-speed broadband to every American,” said Bennet. “For years, the digital divide has prevented up to 42 million Americans—disproportionately from rural areas, low-income neighborhoods, and communities of color—from being able to fully participate in modern American life.”  

In an op-ed published today, Bennet emphasized how the pandemic has pushed Americans to rely on high-speed broadband more than ever to work, learn, and connect remotely. However, up to 42 million Americans still lack access to broadband. Bennet and King’s BRIDGE Act helps close this gap by providing $30 billion to states and $1 billion to tribal governments to deploy broadband in unserved and underserved communities nationwide and ensuring newly built networks meet minimum requirements for speed, service, and affordability. The legislation empowers communities to deploy their own broadband networks if they wish and makes them eligible for financial support. Finally, the legislation accelerates an overhaul of the Federal Communications Commission’s (FCC) broadband maps, which consistently overstate broadband access in America—especially in rural areas.

Read the full text of the bill. (also available: a section-by-section summary and a one-page summary)

Support for the BRIDGE Act from national organizations:

  • Primary Care Collaborative
  • American Library Association
  • American Psychological Association
  • Consumer Reports
  • Fiber Broadband Association
  • Institute for Local Self-Reliance
  • National Association of Realtors
  • National Farmers Union
  • National Rural Health Association
  • Public Knowledge
  • Schools, Health & Libraries Broadband Coalition

 

 

 

 

HHS extends deadline to apply for provider relief funds

September 8, 2020

Healthcare providers now have until Sept. 13 to apply for phase 2 general distribution funding through the Provider Relief Fund (PRF).

In the spring, Congress appropriated money for the PRF to help offset the pandemic’s financial strain on healthcare providers; today, tens of billions of dollars remain in the fund. The Department of Health and Human Services has granted providers an additional two weeks to apply for funding, after an earlier extended deadline in August. Politico reports that many healthcare providers, particularly those serving patients insured by Medicaid and CHIP, have been slow to apply for funding due in part to unclear and changing guidance around eligibility and reporting requirements. The reporting system for PRF recipients is now scheduled to be released Oct. 1.    

Proposed 2021 Medicare Physician Fee Schedule released

September 8, 2020

CMS released its CY2021 Medicare Physician Fee Schedule (MPFS) for comment in August. The proposed rule includes a budget neutrality adjustment to offset, in part, the increased rates for office/outpatient Evaluation and Management services set to take effect this January. The proposed adjustment reduces the Medicare conversion factor by about 10% from $36.09 in 2020 to $32.26. Primary care clinicians will see increases between 8% and 13%, though psychologists and other healthcare specialists would see cuts to their rates. Other MPFS changes include adjustments to reporting and measures for the Medicare Shared Savings Program and MIPS. PCC will work with its Executive Members to develop a comment letter on the proposed rule to meet the Oct. 5 CMS deadline for comments.

New report on capturing non-FFS spending to measure investment in primary care

September 8, 2020

Rand has issued a new report, funded by the Milbank Memorial Fund, that explores how to capture non-fee-for-service spending when measuring levels of primary care investment. Health care continues to move away from traditional claims with greater adoption of alternative payment models. The report identifies key policy decisions that must be answered in order to capture these non-FFS investments — such as risk sharing, provider incentives, HIT, and workforce expenditures — to more accurately measure and compare levels of primary care spending.

This topic will be explored further at the PCC Executive Member and State Policymaker Workshop on Dec. 2.

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