CMS Releases New Proposed Rules  

The Centers for Medicare and Medicaid Services (CMS) have recently released two new proposed rules. The first of the two rules is the physician fee schedule and specifically includes provisions for the use of telehealth. The rule proposes payments for virtual check-ins; remote evaluation of imaging technology including photo and video; telestroke services; and interprofessional telemedicine consultations. The physician fee schedule seeks comments on how these programs should be operationalized to encourage appropriate usage and avoid overemployment. Additionally, CMS seeks input on how telemedicine can be used and paid for in order to support patients struggling with Substance Use Disorders. Comments on the rule are due by September 10.
Yesterday, CMS released the outpatient prospective payment system rule. This rule continues to embrace the payment change previously established by CMS for Part B drugs for those facilities participating in the 340B program. NRHA is pleased they have continued to exclude Sole Community Hospitals from this policy, but we continue to be concerned about the impact of this policy on other rural hospitals. The rule also expands the push towards site neutral payments by capping the payments for clinic visits in hospital outpatient departments to the rate in physician offices. CMS estimates that this cut will be about 60 percent. We are concerned these cuts will further endanger access to care in rural America. As more and more cuts slash away at those resources available for rural providers, we must work to ensure that we preserve the programs that support the rural health safety net. Comments on the rule are due by September 24.
NRHA is continuing to review these two important regulations and will provide updated information. As CMS continues to release new rules, we hope that they will continue the commitment to rural patients and providers that they made with their rural strategy. Any regulation must take into consideration the specific rules and challenges facing rural providers and must provide certainty for the future of rural health care.