Here are six legislative changes:
1. The Oregon House of Representatives passed House Bill 2560, requiring the state's payers to cover follow-up colonoscopy. The bill will require payers to cover colonoscopy following a positive fecal screening test and payers will have to cover follow-up colonoscopy, including polyp removal.
2. CMS announced a one-year grace period for claims with ICD-10 diagnostics codes that go into effect Oct. 1. This will be the third delay for ICD-10 implementation, which was initially set for October 1, 2013.
3. North Carolina's Senate proposed a budget outlining the end of the state's certificate of need program. Senator Tom Apodaca proposed legislation which would eliminate the state CON program, and the provisions are now reflected in the Senate's budget. Federal Trade Commission decided to back a North Carolina-based bill exempting diagnostic centers, ASCs and psychiatric hospitals from the state's certificate-of-need law.
4. CMS released its proposal for policy and payment changes for 2016. The CMS proposes restructuring, reorganizing and consolidating many OPPS Ambulatory Payment Classification systems, resulting in fewer APCs for nine clinical APC families. CMS proposed a 1.7 CPI-U update with a multi-factor productivity adjustment of 0.6 percent.
5. Some Republicans are advocating for reconciliation to change healthcare legislation. Budget reconciliation would permit accelerated consideration of taxes, spending and federal debt limit legislation. The budget resolution sets the reconciliation instruction deadline on July 24, yet many policy makers claim the deadline is irrelevant and Congress has until the end of the 2016 session to pass a reconciliation bill.
6. CMS proposed to pay physicians for optional end-of-life discussion. CPT codes 99497 and 99498 cover a discussion of advance directions up to 30 minutes and the second codes covers an additional 30 minutes. Reimbursements would begin in the first half of 2016, and the decision to issue reimbursement for an active billing code will be made by MACS. MACS would pay for the new codes unless they contest the codes.
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