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DGR Telephone:
703-907-7800 |
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Follow APA Advocacy on Twitter!
The APA Department of Government Relations is now on Twitter! Now you can find out about APA Advocacy activities, Congressional hearings, mark-ups, and floor votes in real time.
Please click on the following link to start following APA Advocacy Twitter:
http://twitter.com/apa_
advocacy
Questions about the Twitter page or how to set up an account? Please contact Kate McAllister or Jason Pray at advocacy@psych.org. | |
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Senate Moves Toward Final Votes on Health Reform
Having secured the solid 60 votes needed to invoke cloture on health reform and thus cut off debate, Senate Majority Leader Harry Reid (D-NV) has the Senate moving steadily ahead to pass a health reform bill before Christmas. The struggle to find the votes forced Senator Reid to drop any public option (including Medicare expansion) from the Senate bill; doing so picked up the vote of Senator Joe Lieberman.
On December 19, Senator Reid released the text of the "manager's amendment" (the final reform language) that has regained the support of Senator Ben Nelson, who had earlier said he would vote against the Senate bill because of his opposition to compromise language on abortion. Nelson was the last holdout and his support gave Senator Reid the 60 votes he has been seeking for weeks. As of this edition of RushNotes, the Senate is expected to vote on final passage on December 24. |
60-day Hold on SGR Cuts
The CY '10 fee schedule rates included a planned 21.2 percent reduction as required under the SGR formula. However, the Department of Defense appropriations bills, now signed into law, included a 60-day delay in these cuts which was passed by both the House and the Senate. The delay freezes payment rates at the CY2009 levels and will allow a grace period while Congress continues to finalize its health reform proposal.
In this regard, CMS has instructed its contractors to hold claims containing services paid under Physician Fee Schedule for the first 10 business days of January (January 1 through January 15) for 2010 dates of service. To the extent possible, providers may hold claims in-house until it becomes clearer as to whether new legislation will be enacted or until cash flow becomes problematic. This will reduce the need for providers to reconcile two payments and it will simplify provider billings of beneficiary coinsurance and payment calculations for payers which are secondary to Medicare.
All claims for services delivered on or before December 31, 2009, will be processed and paid under normal procedures. CMS has extended the 2010 Annual Participation Enrollment Program end date from January 31, 2010, to March 17, 2010- therefore, the enrollment period now runs from November 13, 2009, through March 17, 2010.
You can find the full update and guidance from CMS through the link below:
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Consult Code Update
In the Final Rule discussing the payment policies under the Medicare Physician Fee Schedule for 2010, the Centers for Medicare and Medicaid Services (CMS) announced that Medicare will no longer reimburse for the outpatient and inpatient consultation codes (99241-99245 and 99251-99255). In lieu of these codes, CMS has advised physicians to use the appropriate new patient, initial hospital care or initial nursing facility care evaluation and management (E/M) code for the designated setting. It is important to note that the CPT consultation service codes are not being eliminated, it is just that CMS will no longer reimburse for these codes. It is unclear if private payers will follow suit. The APA and other physician organizations have been lobbying CMS and Congress for a delay in the implementation of the elimination of payment for the consultation codes, which is set for January 1, 2010. However, to help you prepare for the switch, APA has posted more guidance about billing after the change goes into effect, which you can access through the link below.
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New Physician Fee Schedule in Effect on January 1, 2010
The CY '10 Physician Fee Schedule goes into effect on January 1, 2010 and there are a number of issues which may effect your practice, including the elimination of the consultation codes and the unresolved issues related to the sustainable growth rate (SGR) formula. |
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Juvenile Justice Bill makes Senate Progress
After a month-long delay, the Senate Judiciary Committee approved (S. 678) the Juvenile Justice and Delinquency Prevention Act. The Committee also defeated an amendment offered by Senator Jeff Sessions (R-AL) which would have made it easier for states to transfer juveniles into adult prison populations. S. 678 amends the Juvenile Justice and Delinquency Prevention Act of 1974 to reauthorize through FY '14 the juvenile delinquency prevention programs of such Act. Among other things, S. 678 expands requirements for state plans under the Act to require:
(1) statewide compliance with the core requirement of the Act for protection of incarcerated juveniles;
(2) alternatives to detention for juveniles who are status or first-time minor offenders;
(3) use of community-based services to address the needs of at-risk youth;
(4) programs to improve the recruitment, selection, training, and retention of professionals working in juvenile delinquency prevention programs;
(5) the identification of racial and ethnic disparities among juveniles in the juvenile justice system; and
(6) allows funding for personnel recruitment and training, and mental health and substance abuse screening and treatment.
(7) S. 678 now moves to the Senate floor for a vote. |
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Senate Passes Veterans' Health Bill
The Senate, in November, voted to approve an omnibus veterans' health bill, the Caregivers and Veterans Omnibus Health Services Act of 2009 (S. 1963). Sec. 306 of the legislation directs the Secretary of Veterans' Affairs to establish a program to provide peer outreach and support services, readjustment counseling, and other mental health services to veterans of the Iraq war and their families. In areas that are not adequately served by other health facilities, the Department must contract with community mental health centers to provide the services. S. 1963 was agreed to on a vote of 98-0 and was sent to the House, where it has been referred to the Committee on Veterans' Affairs and is awaiting a hearing. |
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Bill to Treat Depression and Bipolar Disorders Introduced in House
A bipartisan group of Representatives Patrick Kennedy (D-RI), Steve Driehaus (D-OH), Patrick Murphy (R-PA), Dan Maffei (D-NY) and John Yarmuth (D-KY) has introduced legislation to establish national centers of excellence for the treatment of depression and bipolar disorders. The bill, known as the ENHANCED Act (H.R. 4204), also authorizes federal support for the development of evidence-based treatment standards and clinical guidelines for improving the detection of depression and bipolar disorder. The bill provides further support to individuals with these disorders by establishing resources for professional education and training and the reduction of the stigma associated with mood disorders. H.R. 4204 is the companion to the Senate bill, S. 1857 introduced by Senators Debbie Stabenow (D-MI), George Voinovich (R-OH), Sherrod Brown (D-OH), John Kerry (D-MA) and Kay Bailey Hutchison (R-TX). | |
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