Advocacy in Action

On September 9th, HRS submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to the Medicare Physician Fee Schedule (PFS) and the Ambulatory Surgery Center (ASC) proposed rules for calendar year (CY) 2025.

For CY 2024, CMS introduced an Office and Outpatient Evaluation and Management (E/M) add-on code, G2211. 

CMS recently released Merit-Based Incentive Payment System (MIPS) payment adjustment information for the 2025 payment year based on 2023 performance scores.

CMS recently announced that clinicians in counties in Florida impacted by Hurricane Debby and in Texas impacted by Hurricane Beryl are eligible for an automatic Extreme and Uncontrollable Circumstances (EUC) exception from MIPS in 2024.

As part of the ongoing implementation of the Inflation Reduction Act (IRA), CMS recently announced the negotiated prices for two key heart medications under Part D, Xalerto and Eliquis, beginning January 1, 2026.

As part of the fiscal year (FY) 2025 Hospital Inpatient Prospective Payment System (IPPS) final rule, CMS finalized a new, mandatory alternative payment model (APM) that would apply to certain hospitals.

The Office of the National Coordinator for Health Information Technology (ONC) recently released its Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) proposed rule, which is a continuation of the HTI-1 rule finalized in December.

CMS recently released its final notice on the Transitional Coverage for Emerging Technologies (TCET), introducing a new pathway for FDA-designated breakthrough devices to obtain Medicare coverage while evidence is collected via the national coverage determination (NCD) process, specifically through coverage with evidence development (CED).

On August 1st, Sens. John Boozman (R-AK) and Peter Welch (D-VT) introduced legislation that aims to protect access to Medicare services by reforming the physician fee schedule.

Sen. Ed Markey (D-MA) and Rep. Pramila Jayapal (D-WA) have introduced a bicameral bill to require greater transparency for private equity firms and for-profit companies that own health care entities.