In mid-November the Centers for Medicare & Medicaid Services (CMS) published the 2016 Hospital Outpatient Prospective Payment System (OPPS) Final Rule, which finalized recommended changes outlined in the proposed rule published this summer. However, proposals to drastically cut payment to in-center sleep testing were averted following comments submitted by the American Academy of Sleep Medicine.

Providers who did not satisfactorily report quality performance through the Physician Quality Reporting System (PQRS) in 2014 are scheduled to receive a negative payment adjustment (penalty) of 2% in 2016. The Centers for Medicare & Medicaid Services (CMS) will accept informal review requests through the QualityNet Portal through Dec. 16, 2015. 

On Oct. 30, 2015 the Centers for Medicare & Medicaid Services (CMS) issued the 2015 Medicare Physician Fee Schedule final rule, which provides updates to payment policies and payment rates for services billed on or after Jan. 1, 2016.

On Monday, Nov. 2, the U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) published the 2016 edition of its annual Work Plan, which includes two investigations related to sleep medicine.

On Friday Oct. 30, the Centers for Medicare & Medicaid Services posted the 2016 Medicare Physician Fee Schedule final rule, which outlines 2016 payment and policies for Medicare physicians.

Recently the Office of the Inspector General (OIG) published findings of an audit conducted on a Florida-based independent diagnostic testing facility (IDTF), which found that the IDTF did not comply with Medicare billing requirements. The AASM encourages all members to review the documentation requirements outlined in your local Medicare coverage determinations (both for sleep testing and DME) to ensure compliance with all requirements.

The U.S. telemedicine market is continuing to grow, according to a new report from HIMSS Analytics.

As the implementation deadline for ICD-10 approaches, the American Academy of Sleep Medicine is expanding its FAQs related to the transition from ICD-9 to ICD-10. 

On Sept. 9 the Centers for Medicare & Medicaid Services (CMS) posted a new fact sheet detailing Physician Quality Reporting System (PQRS) penalties for 2016.