Legislative Recap WE 1/16/21


|
|
|
|
As we move into the new outpatient/ambulatory payment year still in the midst of the COVID-19 pandemic, navigating payment rules across sites of care and ensuring that pharmacy is in sync with their organization’s overall strategies are essential. Themes finalized in the rule sets are: embrace patient centricity, continue to simplify (electronic health record requirements and reporting, regulations), cut costs and save money, and not lose focus on pharmacy’s efforts to combat the opioid crisis.
2021 OPPS Effects
It’s Day 2 of the J.P. Morgan Annual Healthcare Conference at its finest – looking closely at healthcare inequities, strategic business shifts and killer robots, all in the same day! (Yes, we did say killer robots and it’s your reward for reading all the way to the end of this article).
We have moved from last year’s significant emphasis at the JPM Conference on social determinants of health (SDOH) initiatives to a broader discussion of healthcare equity, social justice, diversity and anti-racism, as voiced by many health plans and health systems. Stephen Klasko, Chief Executive Officer of Jefferson Health, said that, “Health disparities are the #1 public health crisis in our nation.” As many noted at the Conference, the COVID-19 crisis is clear evidence that minority and economically disadvantaged communities are medically underserved and bear a higher burden of illness than their more affluent neighbors. Many of the healthcare companies presenting at the Conference expressed their commitment to work to improve those inequities. We look forward to what we will see at next year’s JPM Conference. It also was refreshing to see women Chief Executive Officers presenting at the Conference for leading healthcare companies, like Karen Lynch, the incoming Chief Executive Officer of CVS Health. Kudos for this year’s markedly increased presence on the podium of women in leadership – CEO’s, CFO’s and CSO’s, among others.
On December 27, 2020, the Consolidated Appropriations Act modified the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (MPFS), providing a 3.75 percent increase in MPFS payments. CMS recalculated Ambulatory Surgical Center (ASC) rates for office-based covered surgical procedures and certain covered ancillary radiology services and diagnostic tests, as well as the budget neutrality adjustment applied to all ASC procedure payment rates.