On July 7, 2022, the Centers for Medicare & Medicaid Services (CMS) released the 2023 proposed rule summarizing proposed revisions to the Medicare physician fee schedule (PFS) and Quality Payment Program (QPP). AASM’s health policy team performed an analysis of the proposed rule and [...]
Over the years, sleep medicine physicians have seen continuous reductions in reimbursements, not only because of decreases in physician work due to advances in technology, but largely due to lower conversion factors, budget neutrality, and implementation of payment adjustment sequestration. Diverting the Medicare physician [...]
In April the Office of Inspector General (OIG) announced the release of a new report, which found that Medicare Advantage Organizations (MAOs) had delayed or denied beneficiaries' access to services that meet Medicare coverage requirements under prior authorization requests. The report also found that [...]
The AASM is one of 120 medical specialty societies to sign on to the American Medical Association’s Characteristics of a Rational Medicare Payment System. With more cuts to physician reimbursement looming in 2023, this document outlines principles for a rational and equitable Medicare payment [...]
The AASM is keenly aware of issues that members have been having with coverage of diagnostic tests and treatment during audits due to inconsistencies between AASM clinical practice guidelines and Centers for Medicare & Medicaid Services (CMS) coverage policies, as well as between CMS [...]
Multiple Medicare Administrative Contractors (MACs) have made modifications to local coverage articles (LCAs) after the AASM advocated for the MACs to allow Current Procedural Terminology (CPT) codes 95800, 95801, and 95806 to be reported when home sleep apnea tests are performed in the home. [...]
On Dec. 16, the Centers for Medicare and Medicaid Services (CMS) announced an updated 2022 physician fee schedule conversion factor of $34.6062, according to McDermott+Consulting. This represents a 0.82% cut from the 2021 conversion factor of $34.8931. However, it also reflects an increase from [...]
On Dec. 9, 2021, the American Medical Association (AMA) and American Hospital Association (AHA), along with individual hospital and physicians’ plaintiffs, filed a lawsuit in federal district court against the federal government over what the plaintiffs believe is the ill-advised implementation of the federal [...]
The Centers for Medicare & Medicaid Services (CMS) released the 2022 physician fee schedule final rule earlier in November. The AASM has analyzed the publication and provides the following highlights for sleep clinicians. A separate analysis of the Quality Payment Program final rule will [...]
On Sept. 30, 2021, the U.S. departments of Health and Human Services (HHS), Treasury, and Labor, along with the Office of Personnel Management, released a second interim final rule related to “surprise billing.” AASM previously published a summary of the No Surprises Act and an analysis of part [...]
