2016 a proposal was presented on behalf of CMS to change the current physician payment schedule and replace it. The final rulings will be available November 1, 2016, with implementation taking place on January 1, of 2017.

Currently, behavioral health provider organizations can qualify for meaningful use incentive funds only through the current definition of eligible professionals, which includes physicians and some nurse practitioners that are affiliated with their facilities.

“Generally, the Privacy Rule applies uniformly to all protected health information, without regard to the type of information. One exception to this general rule is for psychotherapy notes, which receive special protections.” 1 “The Privacy Rule defines psychotherapy notes as notes recorded by a health care provider who is a mental health professional documenting or analyzing the contents of a conversation during a private counseling session or a group, joint, or family counseling session and that are separate from the rest of the patient’s medical record.”

According to the Department of Health and Human Services’ (HHS) documentation covering frequently asked questions related to the management of protected health information (PHI) and psychotherapy notes: If providers were required to extend extra protection to a patient’s mental health records, which are to be considered part of their general medical record, then HHS would have made a clear distinction between mental health records and the general health records. Instead, the definition was drawn between psychotherapy notes and the medical record.  1 HIPAA Privacy Rule Information Related to Mental Health

MIPS, or Merit-based Incentive Payment System is the proposed physician fee schedule that would repeal the Medicare sustainable growth rate. Being a merit based system would mean monitoring physician performance and increases or penalties would be based on this performance. Areas of performance measurement totaling to 100 are as follows; quality would be fifty percent, advancing care information twenty-five percent, clinical practice improvement activities fifteen percent and use of resources ten percent. One of the areas of performance is the integration of physical and mental health.

The performance score earned at the end of the year would adjust a provider’s payments from CMS for the second year  following the performance measurement(2017 performance  will influence 2019 payment year) either with an increase of up to four percent of Merit earned is 100, or with a penalty of -4% for if merit earned is zero, through payemet years 2019, increasing to +5%/-5% for 2020, +7%/-7%for 2021, and +9%/-9% for 2022. The merit score for each provider is also available to the public.-Michelle Husted.

(PQRS) was a voluntary program for reporting to CMS (Centers for Medicare and Medicaid).  Starting in 2013, it’s mandatory, and penalties will now be imposed on non-reporting physicians, including psychologists.  If you are enrolled in Medicare under the clinical psychologist designation, have an NPI number, participate in the PECOS program and are reimbursed by Medicare under the Physician Fee Schedule (PFS), you must begin reporting certain quality measures to CMS starting in 2013 or you will start to be penalized in 2015.

Do you agree?

Behavioral health data ‘burdens EHRs’

‘Behavioral health and primary care differ in their language, classifications, codes, data reporting requirements, and regulations’

Current standing of Helping Families in Mental Health Crisis Act of 2016

( Congress is on Vacation July 16 – September 6)

July 14, 2016

Read twice and referred to the Committee on Health, Education, Labor, and Pensions

7/14/2016 Senate Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

Type of Action: Introduction and Referral

07/07/2016 Senate Received in the Senate.

Type of Action: Introduction and Referral

07/06/2016-4:16pm House Motion to reconsider laid on the table Agreed to without objection.

Type of Action: Floor Consideration

07/06/2016-4:16pm House On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 422 – 2 (Roll no. 355). (text: CR H4301-4318)

Type of Action: Floor Consideration

07/06/2016-4:06pm House Considered as unfinished business. (consideration: CR H4333-4334)

Type of Action: Floor Consideration

07/06/2016-2:45pm House At the conclusion of debate, the Yeas and Nays were demanded and ordered. Pursuant to the provisions of clause 8, rule XX, the Chair announced that further proceedings on the motion would be postponed.

Type of Action: Floor Consideration

07/06/2016-1:51pm House DEBATE – The House proceeded with forty minutes of debate on H.R. 2646.

Type of Action: Floor Consideration

07/06/2016-1:51pm House Considered under suspension of the rules. (consideration: CR H4301-4325)

Type of Action: Floor Consideration

07/06/2016-1:51pm House Mr. Murphy (PA) moved to suspend the rules and pass the bill, as amended.

Type of Action: Floor Consideration

07/06/2016 House Placed on the Union Calendar, Calendar No. 517.

Type of Action: Calendars

07/06/2016 House Committee on Education and the Workforce discharged.

Type of Action: Committee Discharge

07/06/2016 House Committee on Ways and Means discharged.

Type of Action: Committee Discharge

07/06/2016 House Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 114-667, Part I.

Type of Action: Committee Consideration

Action By: House Energy and Commerce

Leave a Reply