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CIPROMS News

On July 3, 2014, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (PFS) on or after Jan. 1, 2015. The 224-page document is loaded with information about everything from Ambulance Extender Provisions to ZIP code analysis.
With approximately 110,000 Hoosiers enrolled in health plans via the Federal Health Insurance Marketplace for 2014, all eyes are turning toward 2015, when more than 60,000 additional enrollees are expected to choose from plans offered by as many as nine insurance companies in the state, with premium rates increasing by as much as 46 percent.
At the end of March, hopes of a permanent repeal of the flawed sustainable growth rate (SGR) formula were suddenly dashed by not only another temporary fix, but also by an unexpected delay to ICD-10 implementation of a least one year.  While the Department of Health and Human Services (HHS) later announced their intention to cap the ICD-10 delay at one year--making the new implementation date October 1, 2015--hardly a word has been mentioned about the permanent SGR fix. Where do those efforts stand?