CMS moves that are hurting, helping physicians 

CMS moves are changing the way physicians practice. Here are four recent moves from CMS that are either helping or hurting physicians:

The good

1. CMS announced a program that will accelerate payments to Medicare Part A providers and advance payments to Part B providers who were affected by the Change Healthcare cyberattack. On Feb. 21, Change Healthcare, part of UnitedHealth Group, reported an  incident that disrupted connectivity and healthcare operations nationwide, causing an estimated $100 million daily impact on the healthcare industry.

2. CMS strengthened prior authorization policy with its Interoperability and Prior Authorization final rule. Under the new rule, certain payers have to communicate if and why a prior authorization request is denied. Impacted payers must send prior authorization decisions within 72 hours for expedited requests and seven calendar days for standard requests beginning in 2026.

3. The agency added a Stark law waiver for physician owners of independent, freestanding emergency departments that served Medicare patients during the COVID-19 pandemic.

The bad

4. Congress released a $460 billion spending package that would halve 2024's 3.4% Medicare pay cut for physicians to approximately 1.7%. While physicians say it is a step in the right direction, they also say it is still not enough amid skyrocketing practice costs and increasing consolidation. 

"While we appreciate the challenges Congress confronted when drafting the current 2024 appropriations package, we are extremely disappointed that about half of the 2024 Medicare physician payment cuts will be allowed to continue," American Medical Association President Jesse Ehrenfeld, MD, said March 6. 

And while the Medicare Payment Advisory Commission released a new report to Congress on March 15, some leaders have said its recommendations for physician payments are flawed. 

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