On June 29, 2025, CMS announced the Wasteful and Inappropriate Service Reduction (WISeR) Model, a new payment model under the Center for Medicare and Medicaid Innovation targeting waste, fraud and abuse in Medicare fee-for-service. Unlike Medicare Advantage, Medicare fee-for-service has not previously implemented [...]
On June 9, 2025, the Centers for Medicare & Medicaid Services (CMS) published a national coverage determination (NCD) memo for noninvasive positive pressure ventilation (NIPPV) in the home for chronic respiratory failure (CRF) due to chronic obstructive pulmonary disease (COPD). This decision introduces [...]
On March 24, the Centers for Medicare & Medicaid Services (CMS) announced that the deadline for Merit-Based Incentive Payment System (MIPS) submissions for the Quality Payment Program (QPP) has been extended through 8 p.m. EDT on Monday, April 14. Clinicians and groups who are [...]
On March 14, President Trump signed into law the “Full-Year Continuing Appropriations and Extensions Act, 2025,” extending government operations for the next six months. Despite advocacy from the American Academy of Sleep Medicine and other medical societies in response to the physician fee schedule [...]
In 2024, the American Academy of Sleep Medicine launched the #RepairMedicare campaign, encouraging Congressional leaders to put forth a long-term solution to the consistently declining Medicare reimbursement rates. The AASM continues to advocate for physician payment reform, as the continuing resolution that was passed [...]
On Feb. 3, the Centers for Medicare & Medicaid Services (CMS) announced that the “Extreme and Uncontrollable Circumstances Exception” policy will be applied to Merit-based Incentive Payment System (MIPS) eligible clinicians who have been impacted by the wildfires in California. Performance categories for [...]
In response to prior authorization changes proposed by the Centers for Medicare and Medicaid Services (CMS) in a proposed rule for contract year 2026 changes to the Medicare Advantage Program, the AASM submitted comments to CMS supporting prior authorization reform. These proposed changes [...]
On Friday, Jan. 17, the Drug Enforcement Administration (DEA) published the “Expansion of Buprenorphine Treatment via Telemedicine Encounter Final Rule.” In addition to expanding telehealth flexibilities, the changes aim to balance expanded access with safeguards against drug diversion, which could affect practitioners prescribing [...]
On Jan. 3, the Centers for Medicare & Medicaid Services (CMS) announced that Merit-Based Incentive Payment System (MIPS) submissions for the Quality Payment Program (QPP) can now be submitted and updated through 8 p.m. ET on March 31, 2025. The AASM has developed the [...]
The Centers for Medicare & Medicaid Services (CMS) has posted the revised resource, “How to Use the Office & Outpatient Evaluation and Management Visit Complexity Add-On Code G2211.” The code G2211 reflects visit complexity and increases the value of office and outpatient evaluation and [...]