November 2, 2023

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IN THIS ISSUE

Final 2024 Medicare Physician Fee Schedule release imminent
HHS releases proposed rule outlining provider penalties for information blocking
Proposed changes to No Surprises Act IDR process
White House releases artificial intelligence executive order

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FINAL 2024 MEDICARE PHYSICIAN FEE SCHEDULE RELEASE IMMINENT

The Centers for Medicare & Medicaid Services (CMS) is expected to release the final 2024 Medicare Physician Fee Schedule rule imminently, which in addition to major payment implications, will include changes to the Merit-based Incentive Payment System (MIPS) and alternative payment model (APM) participation options and requirements for 2024. MGMA submitted detailed comments in response to the proposed rule in September.

Once the final rule has been released, MGMA will send an alert to members and provide a more detailed analysis of the final changes to physician payment policies and the Quality Payment Program (QPP) in coming weeks. To learn more about payment and policy changes outlined in the 2024 Medicare Physician Fee Schedule final rule, join MGMA for our member-exclusive 2024 Medicare Outlook webinar on Dec. 7 at 1 p.m. ET.

HHS RELEASES PROPOSED RULE OUTLINING PROVIDER PENALTIES FOR INFORMATION BLOCKING

On Oct. 30, 2023, the Department of Health and Human Services (HHS) released a proposed rule that outlines potential information blocking penalties for healthcare providers. If an investigation from the HHS Office of the Inspector General (OIG) determines a healthcare provider to be in violation of information blocking provisions, said provider may be referred to CMS and incur penalties which include:

For providers participating in the Medicare Shared Savings Program (MSSP), that provider would be ineligible to participate in that program for a year or more.
For providers participating in MIPS, said provider would be ineligible for "meaningful user EHR" status, resulting in a score of "0" in the "promoting interoperability performance category."

This rule is in its proposed stage and enforcement is not anticipated until the rule is finalized. MGMA plans to submit comments on this proposed rule in advance of their due date of Jan. 2, 2024. For additional information, please see the proposed rule fact sheet.

PROPOSED CHANGES TO NO SURPRISES ACT IDR PROCESS

The Administration released a proposed rule on the Independent Dispute Resolution (IDR) process under the No Surprises Act. The proposed rule would establish new batching provisions, change the administrative fee structure, adjust timelines, and facilitate early communication between providers and payers. The Administration states that these changes are being made in response to feedback about challenges with the current process. This proposed rule follows numerous lawsuits and federal court decisions about the IDR process and a separate proposed rule released in October that would implement IDR administrative fees of $150.

There is a 60-day comment period on the proposed rule. The IDR portal is currently open for certain new and bundled disputes, while the initiation and processing of batched disputes and new air ambulance disputes is temporarily closed. More information may be found in the proposed rule fact sheet.

WHITE HOUSE RELEASES ARTIFICIAL INTELLIGENCE EXECUTIVE ORDER

The White House released an Executive Order (EO) on the development and use of Artificial Intelligence (AI). The wide-ranging EO outlines eight guiding principles to oversee AI, including improving safety and security, promoting innovation, and advancing equity.

The EO instructs various federal agencies to develop policies and guidelines for industries impacted by AI. Focusing on a number healthcare-specific areas, the EO calls on HHS to take numerous steps like establishing an AI Task Force to create a strategic plan within one year.

UPCOMING CALENDAR & EVENTS

2023 MIPS Value Pathways (MVPs) registration deadline
NOVEMBER 30, 2023 at 8 PM ET

MGMA's 2024 Medicare Outlook Webinar
DECEMBER 7, 2023 at 1 PM ET

2023 MIPS EUC Exception application deadline
JANUARY 2, 2024 at 8 PM ET

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