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Washington Debrief: Five Weeks until ICD-10, CMS Announces National Call

August 24, 2015
by Leslie Kriegstein, Interim Vice President of Public Policy, CHIME
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Congressional Affairs:

Senators Release Draft of Telemedicine Expansion Bill

Key Takeaway: Conversations continue on Capitol Hill about how to expand the use of telehealth services and address the ongoing concerns about reimbursement for remote care in the Medicare program.

Why It Matters: Draft legislation is being circulated by three Senators, John Thune (R-SD), Brian Schatz (D-HI) and Roger Wicker (R-MS), requires the government to pay for telemedicine services at the same rate it does for in-person visits.

The draft includes a program to assist doctors in establishing telemedicine or remote monitoring programs under Medicare’s new Merit-Based Incentive Payment System, which was created when Congress repealed the flawed Sustainable Growth Rate (SGR) reimbursement structure for physicians.

The bill also includes a directive for Medicare to reimburse telemedicine in new models such as accountable care organizations (ACOs) and bundled payments. The draft also includes a mandate that Medicare pay for remote monitoring of patients with chronic conditions for up to 90 days, provided certain conditions are met. A patient’s home would be considered an “originating site” and federally qualified health centers would be acceptable “distant sites.”

The bill does not open up telemedicine payments in the entire fee-for-service Medicare program, except for home kidney dialysis treatments.

Federal Affairs

PCAST Report Speaks to Need for Open Standards, Interfaces to Improve Interoperability

Key Takeaway: The President’s Council of Advisors on Science and Technology made a series of recommendations aimed to spur research and development in a number of key areas including cybersecurity and health IT.

Why It Matters: The lack of open standards and interfaces was noted as a hindrance to data exchange systems by the President’s Council of Advisors on Science and Technology (PCAST) as stated in a report released earlier this month.

The August report, delivered to the President and Congress, titled, “Ensuring Leadership in Federally Funded Research and Development in Information Technology,” focused on eight research and development areas, including: cybersecurity, IT and health, big Data and data-intensive computing.

According to the report, “Many opportunities for research, however, are inhibited by significant barriers in gaining access to health data and the lack of standards to ensure inter-operability and promote technology and data exchange.”

The report cites that new technologies are not introduced as often into healthcare as in other settings where, “open standards, public data sets, and fewer regulatory hurdles allow for rapid innovation, testing, and evolution of technology that can have tremendous benefits in health care.”

Further, the report recommended additional focus be dedicated at the National Science Foundation (NSF) and other federal agencies to set the framework for trustworthy systems. Another recommendation addressed the need for improved attribution identifying the source of an attack so that both technical and non-technical mitigations are possible.

HHS Announces National “Countdown to ICD-10” Call

Key Takeaway: The Medicare Learning Network is hosting a national call for medical, billing and administrative staff on August 27 to offer final advice for the transition to ICD-10 coding.

Why It Matters: The Centers for Medicare and Medicaid Services (CMS) continues to indicate the October 1 ICD-10 implementation date is firm. As part of the Agency’s ongoing efforts to share resources and mitigate persistent readiness concerns, CMS announced the “Countdown to ICD-10” national call scheduled for August 27 from 2:30 – 4:00 p.m. ET.

According to CMS, the topics to be covered will include: how to get answers to coding questions, claims that span the implementation date, results from acknowledgement and end-to-end testing weeks and where to find additional provider resources.

CMS stated that the target audience for the call is, “Medical coders, physicians, physician office staff, nurses and other non-physician practitioners, provider billing staff, health records staff, vendors, educators, system maintainers, laboratories, and all Medicare providers.”

Registration information is available here.