Strong Support for Our Local Doctors in Year-End Package
- Bans Surprise Medical Bills and Creates a Fair Dispute Resolution Process.
- Protects patients from surprise medical bills while rejecting price setting schemes and attempts to limit providers’ access to arbitration.
- Explicitly bans the arbiter from considering government-set rates.
- Accommodates physician stakeholder concerns about the timeline surrounding arbitration by giving providers more flexibility to when they can start the process.
- Creates an interim report to Congress two years after enactment to ensure rigorous oversight of the development of the arbitration process.
- Adds additional flexibility for the Secretary to establish the “90 day cooling off period” in a manner that ensures all claims are eligible for arbitration.
- Increases physician pay across the board, stops planned Medicare cuts and mitigates at least two-thirds of the cuts to certain providers due to Medicare budget neutrality requirements.
- Blocks a new code created in the latest physician fee schedule rule for three years, which is projected to mitigate these cuts by a third.
- Injects $3B into the physician fee schedule in 2021, resulting in payment increases across the board.
- Continues the current Alternative Payment Model (APM) thresholds for two additional years, allowing more providers to qualify for the 5 percent APM payment who would otherwise have been disqualified because of statutory increases in threshold amounts.
- Delays the 2 percent sequester cuts that were supposed to resume January 1, 2021, for three additional months.
- Supports Medicare physician workforce development by providing for the distribution of 1,000 additional Medicare-funded graduate medical education (GME) residency positions.
- Dedicated funding for physician training in rural and underserved areas.
- Allows patients entering hospice care to keep their same doctor from a federally qualified health center or rural health center.
- Expands permanently telehealth for mental health services.
- Delays implementation of the radiation oncology model anther six months to give providers more time to adapt to the new payment system.
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