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Thanks to the many AGS members who have contacted Congressional representatives to convey concerns about the proposed change to the evaluation and management (E/M) payment codes in the Medicare Physician Fee Schedule Proposed Rule for 2019 (#MPFS2019).  Several AGS leaders who made these calls noted that Congressional staff are interested in gaining a better understanding of the proposal and the concerns we have. You may find it helpful to include these links in follow-up thank you notes (also a great best-practice recommendation) to Hill staff, who may end up using these resources to further educate your representatives:   The American Medical Association ...
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We now have a little over two weeks to the deadline (9/10) for comments on the #MPFS2019, so you can probably imagine the fever-pitched pace of our work as we round the bend on our final lap. Here are some highlights from the last week’s worth of action and activity:  What We’re Drafting/Doing In collaboration with our coalition, we’ve put two draft comment letters on the table for consideration. As our thinking currently stands, our first letter—intended for the Centers for Medicare & Medicaid (CMS) specifically—will detail our concerns around the evaluation and management (E/M) coding proposal and make recommendations for moving forward. Our ...
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Since my initial blog post about the proposed #MPFS2019 rule, AGS leaders, staff, and consultants have been working on our response to the proposed changes that CMS has put forward.  To date, we have largely maintained a focus on the E/M proposal because of the implications that that has for our members. In addition, our leaders, staff, and consultants have also reviewed the entire proposed rule to identify the proposals that could impact care of older Americans and we have engaged additional AGS leaders to help us with our comments. It really does take a village to analyze and then respond to a 1,400 page rule. On E/M, our work (which is described in more ...
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The Centers for Medicare and Medicaid Services (CMS) recently released the Medicare Physician Fee Schedule Proposed Rule for 2019 (#MPFS2019) . As a refresher: The #MPFS2019 outlines how the Centers for Medicare and Medicaid Services (CMS) intends to update Medicare payment policies for the year ahead. Every summer, reviewing and providing feedback to @CMSgov on #Medicare payment is a major focus for our AGS experts, regulatory consultants, and policy staff. This year, for the first time, @CMSgov combined the #MPFS2019 and what is normally a separate rule regarding plans to update the Quality Payment Program (#QPP). The result is a 1,400-page proposal which ...
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Hopefully everyone had safe trips back from #AGS18.  While we were away, the Trump Administration  unveiled a "recissions package," or a request for Congress to rescind certain spending items.  Many of the funds the Administration wants to cut are "unobligated," meaning they are leftover from programs that have not been reauthorized or no longer exist.    If Congress passes the rescissions package (which remains an uncertainty), it could make it more difficult to pass other kinds of spending legislation throughout the year. From HHS, the White House is proposing to rescind: $5.15 billion from the Children’s Insurance Fund (authority to obligate these ...
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Health Reform Update

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Hi, all. While you’re busy packing for #AGS18, here’s some great #geriatrics reading to keep you occupied: A summary of health reform action to-date from our consultants with Arnold & Porter in D.C. Happy reading! Nancy * * * What’s Happened When the 115 th Congress began, Republicans were very well-positioned to pass their ACA repeal/Medicaid reform package, as they controlled both chambers of Congress and the Administration. Their multiple attempts, however, got stuck in the Senate, which was unable to pass ACA repeal even under the budget reconciliation, which requires only a majority vote, as opposed to the standard three-fifths majority ...
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Last June, I had an opportunity to participate in the “Inclusion Across the Lifespan” workshop (Lifespan Workshop) that was held on the National Institutes of Health (NIH) campus in Bethesda, MD. For the past several years, I’ve been joining the AGS Research Committee delegation for its annual meeting with Drs. Hodes and Bernard and the many other NIA program staff that champion aging research across the NIH. Like those meetings, walking on the NIH campus reminded me of the important role that NIA has played in building the evidence base for geriatrics and improving how we care for older people.  I am delighted that the Lifespan Workshop led to a revision ...
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Both Houses of Congress have been moving quickly on plans for tax reform—and that may leave you with questions about what the House and Senate have proposed and how it might impact you, older adults, and caregivers. CQ has published a side-by-side comparison of each tax reform proposal.  You can access the full analysis here , with highlights below: The  New York Times also created an interactive graphic visualizing the impact of the tax bill's automatic spending cuts on a host of federal programs (assuming Congress takes no other action following potential passage of the bill)
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In light of ongoing health reform debates and a significantly shorter open-enrollment period for 2018, it’s no surprise that Americans—including older Americans and caregivers—have a lot of questions about health coverage. Here are five things you and your patients need to know about the Health Insurance Marketplace (sometimes known as the health insurance “exchange”).  Americans with Medicare may have questions about the insurance marketplace. If you are on Medicare, you can't switch to Marketplace insurance, supplement your coverage with a Marketplace plan, or buy a Marketplace dental plan. Learn about Medicare and the Marketplace here. If ...
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Acute Hospital Care

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I hope you enjoyed the annual meeting of the American Geriatrics Society in San Antonio.  On behalf of Drs. Mike Malone and Kyle Allen I thank those of you who attended the Acute Hospital Care SIG meeting. We heard very exciting presentations from Drs. Neela Patel and Kevin Biese. I am interested in hearing from you about your experiences related to acute hospital care, ACE or virtual ACE units. I welcome suggestions for topics and speakers for future SIG meetings as well ideas about how  to keep ourselves up to date on hospital-related issues. --Bob Palmer
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As we start week two of Congress’ spring recess, I am hoping that AGS members will consider lending their voices to our efforts to increase Congressional awareness of and support for the Geriatrics Workforce Enhancement Programs (GWEPs). The 44 GWEPs are training health professionals, direct care workers, and family caregivers in 29 states with the goal of improving the health and quality of life of older adults. In addition, these programs are important sources of support for geriatrics clinician-educators in nursing, medicine, and a host of other health professions.   Among our GWEP-related concerns for AGS members in the President’s "skinny budget" is ...
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