Maine Medicine Weekly Update - 07/30/2018  (Plain Text Version)

Return to Graphical Version


In this issue:
•  Maine Medical Center and Tufts Continue Collaboration for Medical Education
•  MICIS 3-hour Opioid CME Presentations - registration open for August 21 in Brewer
•  CMS Releases Proposed 2019 Medicare Payment Rule
•  Licensing Boards Discuss Nursing Home Exception to Opioid Requirements
•  MMA Board of Directors Meets Friday for Summer Board Meeting
•  Prescription Monitoring Program User Survey
•  Time to Volunteer for an MMA Committee
•  Computerized Provider Order Entry (CPOE) Myth
•  Azar: HHS to rewrite health care privacy rules
•  Correction of Last Week's Update
•  MMA Presentation on Healthcare Issues Considered by 128th Legislature Now Available
•  Childhood Development and Behavior Conference At Colby August 2-3
•  Maine Quality Counts Offers Project ECHO Medication Assisted Treatment Course
•  17th Annual Downeast Ophthalmology Symposium - September 21-23, 2018
•  Hanley Center Offers New PELI Course Beginning in October
•  Northern New England Society of Addiction Medicine 2018 Annual Conference & Meeting - Nov 2-3
•  Hanley Center Offers Next Level Leadership Seminar Series and Advanced Practice Provider Leadership Institute
•  Advanced Hanley Center Training Available for PELI and HLD Alumni
•  Behavioral Health Consultant
•  Clinical Cardiology Opportunity
•  Internal Medicine Outpatient Physician
•  Nurse Practitioner - Nasson Health Care
•  Medical Board Physician
•  Medical Director/Family Practice Physician - Relocate to Beautiful Southwestern Maine
•  Outpatient Internal Medicine Physician Bangor, Maine
•  Psychiatry Faculty, Division of Child & Adolescent Psychiatry
•  Maine's Largest FQHC in need of Physician for Geriatric Program
•  Multiple Family Med Opportunities in Beloved Community Health Centers
•  Opportunities at the VA for Volunteer Physicians


CMS Releases Proposed 2019 Medicare Payment Rule

See important changes in Medicare physician payment policy and MIPS proposed by CMS.


On July 12, the Centers for Medicare & Medicaid Services (CMS) released a 1,500-page proposed regulation pertaining to the 2019 Medicare Physician Fee Schedule and Quality Payment Program. CMS also issued Quality Payment Program (QPP) and Physician Fee Schedule (PFS) fact sheets on the proposed rule. An initial AMA summary of the proposal is available on the AMA website.

The proposed policies are open for public comment until Sept. 10. Key Medicare Physician Fee Schedule proposals include:

  • A slight increase in the conversion factor from $35.99 to $36.05.
  • Collapsing payment rates for office and outpatient visits, such that new patient office visits (99202–99205) would be blended to a single rate of $135, and established patient office visits (99212–99215) would be blended to a single rate of $93.
  • Add-on payments would be made to office visits for specific specialties ($14) and primary care physicians ($5). 
  • Substantial changes to the documentation guidelines for office and outpatient visits intended to reduce administrative burdens and address "note bloat." For example, documentation for history and an exam will focus on interval history since last visit, and physicians will be allowed to review and verify certain information in the medical record entered by ancillary staff or the patient instead of re-entering the information.
  • A new multiple procedure reduction policy for visits and procedures reported on the same date.
  • Coverage and payment for new Current Procedural Terminology (CPT®) codes for remote monitoring and interprofessional consultations.

Highlights of the Merit-based Incentive Payment System (MIPS) proposals include:

  • Retaining the low-volume threshold and adding a third criteria of providing fewer than 200 covered professional services to Part B patients.  
  • Retaining bonus points for complex patients, end-to-end reporting and small practices.
  • Allowing eligible clinicians to opt-in if they meet one or two, but not all, of the low-volume threshold criteria.
  • Eliminating the base and performance categories and reducing the number of measures in the Promoting Interoperability (formerly advancing care information) category.
  • Requiring eligible clinicians to move to 2015 Certified Electronic Health Record Technology (CEHRT).
  • Providing the option to use facility-based scoring for facility-based clinicians.
  • For the 2019 QPP performance year, the MIPS category weights are: Quality—45 percent; cost—15 percent; Promoting Interoperability—25 percent; Improvement Activities—15 percent.

The AMA Advocacy team will convene discussions with CMS representatives and other physician groups over the next few weeks to inform our formal comments on the proposed rule.