February 7
IN THIS ISSUE / FEBRUARY 7, 2018
- Generic drug prices: What to expect in 2018
- February Access Hero: Dr. Brodell
- CMS expands Extreme and Uncontrollable Circumstances policy
- Network inaccuracies worsen
- Fewer physicians opting out of Medicare
Generic drug prices: What to expect in 2018
The U.S. Food and Drug Administration (FDA) approved 1,027 generic drugs in 2017 ― a record high, says the Administration. According to the FDA, increased competition in the generic drug space could improve drug prices and patient access. “We know that enabling more generic competition, where Congress intended, helps reduce prices, enable more access, and improve public health,” said Scott Gottlieb, FDA commissioner, in October.
While lawmakers attempt to address this issue, soaring prices for generic drugs have forced some dermatologists to rethink common therapies. Read more about gargantuan growing generic prices in Dermatology World.
Related Links:
- A tangled web: What’s happening with drug costs and what’s being done to bring costs down – Dermatology World (September 2017)
- Battling for biologics – Dermatology World (September 2015)
- Check out the Academy’s new Practical Approaches to Assessing Psoriasis and Psoriatic Arthritis Patients in Clinic
February Access Hero: Dr. Brodell
Mississippi has about 48 dermatologists for three million people, and some parts of the state — like the Delta — don't have a dermatologist for about 100 miles. Learn how Robert T. Brodell, MD, increased access to dermatology for Delta residents.
Each month, the Academy highlights members’ diverse efforts to expand access to dermatology. Submit your story at www.skinserious.org.
- Access granted: Improving access for referrals – Dermatology World (October 2017)
- Lending a hand: Physicians discuss the rewards and challenges of caring for the underserved – Dermatology World (December 2015)
- Can better access to dermatologists improve melanoma prognosis? – Dermatology World (February 2015)
CMS expands Extreme and Uncontrollable Circumstances policy
The Centers for Medicare and Medicaid Services (CMS) has updated its ‘Extreme and Uncontrollable Circumstances’ policy for the 2017 Merit-based Incentive Payment System (MIPS) to include providers located in counties affected by Hurricane Nate and additional counties affected by the California wildfires. According to CMS, “MIPS eligible clinicians in Federal Emergency Management Agency (FEMA) designated areas affected by Northern California wildfires and Hurricanes Harvey, Irma, Maria, and Nate will be automatically identified. No action is required. However, if you are automatically identified but still choose to submit data on two or more MIPS performance categories (either as an individual or group), you’ll be scored on those performance categories and your MIPS payment adjustment will be based on your final score.”
After requiring dermatologists to report one measure one time in 2017 to avoid a 4% penalty in 2019, Medicare has raised the stakes and the requirements in 2018. Read more about MIPS reporting in 2018 in this month’s issue of Dermatology World.
Related Links:
- What are your plans for MIPS reporting in 2018? – Dermatology World (January 2018)
- MACRA and MIPS tips – Dermatology World (July 2017)
- AAD DataDerm™
- Academy MACRA Resource Center
- Live webinar: MIPS and its Impact on Coding & Documentation – May 17, 2018
- Academy product: Principles of Documentation for Dermatology, First Edition
- Academy product: 2018 Coding and Billing for Dermatology
Network inaccuracies worsen
According to a new report issued by CMS, more than 50% of the online directories that list in-network doctors maintained by Medicare Advantage plans had inaccuracies, such as wrong phone numbers and addresses listed for providers ― an increase from the 45% of directories that had errors in last year’s review.
Inaccuracies aren’t the only troubling trend occurring among provider networks. Read more about the implications of providers’ policies regarding narrowed networks, physician tiering, and squeezed drug formularies in Dermatology World.
Related Links:
Fewer physicians opting out of Medicare
According to a report released by CMS, the number of providers who opted out of Medicare dropped to 3,732 in 2017 ― down from 7,400 in 2016. While CMS did not offer a reason for this decrease, the Medicare Access and CHIP Reauthorization Act (MACRA) ended the provision requiring providers to renew their opt-out requests every two years. Therefore, opt-out requests are indefinite until a provider requests to re-join.
Increasing federal administrative requirements and regulations may be contributing to physician burnout, say experts. Read more about the sources of dermatologist burnout and mitigating strategies in Dermatology World.
Related Links:
