June 04, 2020

ACR Supports Temporary Flexibilities to Medicare Rules

In comments recently submitted to the Centers for Medicare and Medicaid Services (CMS), the American College of Radiology® (ACR®) expressed support for temporary policy and regulatory revisions to the Medicare program in response to the COVID-19 public health emergency (PHE).

CMS issued the first of two interim final rules with comment (IFC) in early April to allow healthcare providers flexibilities to continue providing services to patients while minimizing infection risk for both patients and providers.

While the ACR largely supports the changes implemented by CMS, it urged caution regarding long-term use of telecommunications technology for direct supervision of medical procedures and the relaxation of supervision for outpatient hospital therapeutic services from direct level supervision to general supervision. The ACR asked CMS to carefully analyze these decisions after the PHE declaration ends to ensure the highest level of patient care and safety.

With regard to the Medicare Shared Savings Program (MSSP), CMS has declared that for the performance year (PY) 2020 financial reconciliation, the agency will reduce an accountable care organization’s (ACO) shared losses by an amount determined by multiplying the shared losses by the percentage of the total months in the performance year affected by the PHE and the percentage of an ACO’s beneficiaries that reside in an affected area.

The ACR asked CMS to eliminate downside risk for PY 2020 of the MSSP, thus waiving shared losses.

Further, the ACR supports recent letters sent to the CMS Administrator from Senator Sheldon Whitehouse and Senator Bill Cassidy, as well as the Medicare Payment Advisory Commission (MedPAC). In their letter to the CMS Administrator, Senators Whitehouse and Cassidy urged CMS to waive the shared loss repayment for ACOs for PY 2020. MedPAC similarly urged the CMS Administrator not to use 2020 data to determine ACO performance for purposes of computing ACO quality, bonuses or penalties. The ACR agrees with the recommendations not to use 2020 data to determine ACO performance for purposes of computing ACO quality, bonuses or penalties.

The ACR comment letter also addressed site-of-service payment differentials for telehealth services, expansion of telehealth for on-treatment visits, application of certain National Coverage Determination and Local Coverage Determination requirements during the PHE and a request to revise the treating physician rule for radiologists.

Questions related to CMS policy changes as a result of COVID-19 and the ACR response to the IFC should be directed to COVID19@acr.org.