The Outpatient Prospective Payment System and Physician Fee Schedule final rules for calendar year 2019 expand damaging site-neutral payment policies and continue Medicare Part B drug payment cuts to hospitals in the 340B Drug Pricing Program.

The rule includes updates to the Quality Payment Program and documentation and payment changes for evaluation and management services.

The association urged the Centers for Medicare & Medicaid Services to adequately reimburse off-campus, provider-based departments and refine physician quality reporting to account for costs of care and the unique needs and patient populations served by essential hospitals.

Bills to repeal the medical device tax and expand health savings accounts go to a House floor vote; a House committee advanced legislation that would fund the Hospital Preparedness Program at about $265 billion annually.

In the rule, the Centers for Medicare & Medicaid Services continues a policy of reduced payments to new off-campus provider-based departments; the agency also provides updates to the Quality Payment Program.

The project would waive Merit-based Incentive Payment System requirements for clinicians who participate in certain Medicare Advantage plans that involve taking on risk to better align such plans with fee-for-service Medicare.

Merit-based Incentive Payment System participants can request a targeted review of their performance feedback and final score if they find an error in their 2019 payment adjustment calculation.

Clinicians eligible for the Merit-based Incentive Payment System can receive Improvement Activity credit for participating in a study on quality reporting burdens; applications are due April 30.

Providers who submitted data through the Quality Payment Program website can review preliminary performance feedback. Final scores and feedback will be available July 1.

In its annual report to Congress, the commission also recommends curbing Medicare Advantage plan consolidation and evaluating telehealth services before including them in coverage.

Group reporting through the Centers for Medicare & Medicaid Services web interface must be completed by March 16; all other Merit-based Incentive Payment System data must be submitted by March 31.

The table identifies which alternative payment models (APMs) are designated as Advanced APMs under the Quality Payment Program or the Merit-based Incentive Payment System.

The new system streamlines quality reporting through one portal; the data submission period runs from Jan. 2 to March 31.

In response to an annual update to the Quality Payment Program, the association called for increased flexibility and risk adjustment for socioeconomic factors.

Final regulations for Medicare physician payments will increase merit-based payments to account for complex patients, allow physicians to participate in virtual groups, adjust the threshold for defining low-volume practices, and make numerous other changes.

The Quality Payment Program combines and replaces three separate clinician quality programs with a single system for clinicians that bill Medicare Part B.

The Centers for Medicare & Medicaid Services will conduct field testing from Oct. 16 to Nov. 15 of eight episode-based cost measures for the Merit-based Incentive Payment System.

Clinicians can participate in the first year of the Merit-based Incentive Payment System and avoid a negative payment adjustment if they begin collecting data by Dec. 31.

Merit-based Incentive Payment System–eligible clinicians and groups may apply for hardship exceptions due to connectivity issues or extreme circumstances, such as disasters.

In response to a proposed annual update to the Quality Payment Program, America’s Essential Hospitals offered recommendations related to the merit-based incentive payment system.

Exceptions are available for Merit-based Incentive Payment System eligible clinicians and groups that experienced insufficient internet connectivity, uncontrollable circumstances, or other issues; applications are due Oct. 1.