Here is a recap of changes CMS made to covered procedures, payments and more in 2022 for ASC leaders to know.
- The Medical Group Management Association wrote a letter to Congress urging lawmakers to intervene over physician pay cuts.
- CMS increased the pay rate for iTind procedures in ASC and hospital outpatient departments.
- CMS reduced the physician pay conversion factor by 4.48 percent for 2023.
- Nine physician leaders were unhappy with the announced physician fee cuts.
- CMS released its 2023 payment and procedure updates for ASCs and hospital outpatient departments, finalizing an update of 3.8 percent. CMS also added four new ASC procedures to the list of covered services: 19307, mast mod rad; 37193, rem endovas vena cava filter; 38531, open bx/exc inguinofem nodes; and 43774, lap rmvl gastr adj all parts.
- A group of federal and industry safety leaders issued an urgent call for healthcare organizations to rebuild the foundations for safe care that deteriorated during the pandemic.
- The Supreme Court upheld the HHS approach to calculating certain Medicare payments to hospitals that serve a large number of low-income patients.
- Oversight of the COVID-19 vaccination mandate covering healthcare facilities participating in Medicare and Medicaid was removed from all CMS surveys.
- The Supreme Court sided with hospital groups in a case challenging HHS' 340B payment cuts.
- The Supreme Court ruled that states can seek reimbursements for future medical care from Medicaid beneficiaries who win money in personal injury litigation.
- HHS gave states an extra year, through March 31, 2025, to use funding from the American Rescue Plan to improve home- and community-based services.
- The CDC stopped collecting hospitals' data on suspected cases of COVID-19 that have not been confirmed by tests.
- HHS issued a final rule May 26 withdrawing the Securing Updated and Necessary Statutory Evaluations Timely, or SUNSET, rule.
- A third round of free at-home COVID-19 tests from the U.S. government was made available at covidtests.gov.
- HHS and the Office of Climate Change and Health Equity released the first installment in its climate and health series. The series aims to connect weather forecasts for extreme events such as heat waves, wildfires and droughts to health resources to reduce the number of weather-related illness and death.
- HHS implemented continuous monitoring of its systems, after an audit conducted by the department's office of the inspector general found its information security program "not effective" for fiscal year 2021.
- CMS proposed 1,495 changes to the ICD-10-CM diagnostic code set in its proposed Inpatient Prospective Payment System rule. A large portion of the proposed changes focused on brain illness and injuries, mostly dementia-related diagnoses and endometriosis.
- Stacey Hughes, executive vice president of the American Hospital Association, said CMS' proposed payment increase of 3.2 percent, or $1.6 billion, for fiscal year 2023, is inadequate due to inflation and labor and supply costs.
- CMS updated its guidance that made arbitrators consider more than an insurer's median in-network rates for billed items when deciding surprise-billing disputes.
- CMS proposed lower payment rates to skilled nursing facilities by 4.6 percent, which decreases Medicare payments to facilities by about $320 million.
- CMS answered questions about requirements of the No Surprises Act and about giving good faith estimates to uninsured and self-pay patients.
- CMS said it will pay for a second COVID-19 booster shot for people covered under Medicare and Medicaid.
- CMS released its final 2023 Medicare Advantage capitation and Part C and D rate announcement.
- The Government Accountability Office recommended CMS assess the effect increased telehealth use is having on the quality of care received by Medicaid beneficiaries.
- CMS released its annual proposed payment update for hospices, which would raise payment rates in fiscal year 2023.
- The Senate passed legislation that aimed to halt the CMS federal COVID-19 vaccination mandate for eligible healthcare workers participating in Medicare and Medicaid programs.
- CMS reopened the Merit-based Incentive Payment System automatic extreme and uncontrollable circumstances application for groups, virtual groups and Alternative Payment Model entities through March 31.
- In an effort to improve health equity, CMS changed to the Global and Professional Direct Contracting model after receiving stakeholder feedback.
- CMS ended the ACO transformation track in the Community Health Access and Rural Transformation Model.
- CMS released its Medicare payment codes for administering an antibody treatment found effective against the COVID-19 omicron variant.
- Sixteen state attorneys general asked a federal judge Feb. 4 to block the CMS vaccination mandate for healthcare workers.
- CMS trimmed 764 hospitals' Medicare payments in fiscal year 2022 for having the highest rates of patient injuries and infections.
- CMS proposed a rule to cut prescription drug costs, increase contract vetting and improve health equity.