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Center Comments on 2025 Physician Fee Schedule, Outpatient Prospective Payment System

September 11, 2024

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Center for Medicare Advocacy Submits Comments on Proposed Physician Fee Schedule Rule

On July 31, 2024, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule titled “Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments,” commonly referred to as the Physician Fee Schedule (PFS) rule, available here. The Center submitted comments to the rule on September 9, 2024, which are available here.

Comments on Outpatient Prospective Payment System (OPPS) and ASC Payment System Proposed Rule

On September 9, 2024, The Center for Medicare Advocacy submitted comments to the (CY) 2025 Outpatient Prospective Payment System (OPPS) and ASC Payment System Proposed Rule. The Center supported the proposal to narrow the definition of “custody” to no longer include individuals on bail, parole, probation, or home confinement. Narrowing the definition of custody can help remove hurdles for recently incarcerated individuals accessing healthcare and Medicare coverage. Similarly, the Center supported aligning the eligibility criteria for the Medicare Special Enrollment Period (SEP) for recently incarcerated individuals with criteria used by the Social Security Administration (SSA) to suspend and reinstate OASDI benefits. The intent of the proposed rule is to streamline Medicare enrollment for recently incarcerated individuals by referencing criteria and data already utilized by the SSA.  The Center’s comments are available here.

September 11, 2024 – K. Kertesz & C. Huberty

Filed Under: Article Tagged With: comment, Weekly Alert

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