CMS Proposes Big Medicare Changes for 2019


The Centers for Medicare & Medicaid Services (CMS) last week proposed what the agency called “historic changes” in the Medicare program. TMA is already digging deep into the proposal to make sure the changes are good for Texas physicians and your patients.

“Today’s proposals deliver on the pledge to put patients over paperwork,” said CMS Administrator Seema Verma. “The proposed changes to the Physician Fee Schedule and Quality Payment Program (QPP) address those problems head-on, by streamlining documentation requirements to focus on patient care and by modernizing payment policies so seniors and others covered by Medicare can take advantage of the latest technologies to get the quality care they need.”

Texas Medical Association President Douglas Curran, MD, said the association welcomes that approach.

“Physicians are among the most regulated professionals in the country,” Dr. Curran said. “The paperwork burdens and administrative hassles come between doctors and our patients, and are significant causes of the epidemic of physician burnout. That's why TMA has repeatedly petitioned CMS to remove the yoke of unnecessary regulation.”

U.S. Rep. Michael Burgess, MD (R-Lewisville), chair of the House Energy and Commerce Subcommittee on Health, agreed. "These proposed changes seek to strengthen the critically important doctor-patient relationship by reducing unnecessary reporting burdens,” Representative Burgess said.

TMA staff experts have begun a detailed analysis of the proposed rule and will offer written comments by the Sept. 10 deadline. As always, staff will work with TMA’s various councils and committees as the comments are drafted, but if you have something specific you would like to say, please pass it on by emailing hit[at]texmed[dot]org.  

The Physician Fee Schedule establishes payment for physicians and other clinicians who treat Medicare patients. 

CMS created the QPP under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The program uses a framework of integrated policies for the two Medicare payment tracks required by MACRA: the Merit-based Incentive Payment System (MIPS) and advanced alternative payment models. 

The Physician Fee Schedule and QPP are updated annually to create, update, or change program and payment policies, payment rates, and other provisions that govern them. 

Over the past two years, CMS published two separate rules for the Physician Fee Schedule and QPP, but this year it rolled both sets into one massive 1,473-page proposed rule. 

Physicians can find the pre-publication version of the proposed rule in the Federal Register. For an overview of policy proposals, refer to the CY 2019 Physician Fee Schedule news release and CY 2019 Quality Payment Program fact sheet.

Stay tuned as Texas Medicine Today will bring you a summary of TMA’s findings and recommendations in the coming weeks.  

Last Updated On

July 19, 2018

Originally Published On

July 16, 2018

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