New year, new health care policies, and Legacy Consulting Services has team members on stand-by to help you navigate it all.

In December, lawmakers passed a massive $1.7 trillion spending package that included a 2 percent cut in Medicare payment for physicians. The new law – called the Consolidated Appropriations Act of 2023 – also contains some key provisions that physicians should understand. Here are some highlights:

Telehealth

• Telehealth flexibilities instituted due to the COVID-19 crisis have been extended through 2024
• During the pandemic, restrictions were relaxed on who could provide telehealth services and from where
•  The law delays the requirement that a Medicare beneficiary attend an in-person visit with their provider prior to receiving behavioral health services via telehealth

Alternative Payment Model (APM) Bonuses

• One-year extension of the bonus for providers who are part of APMs
• Bonus will be dropped from 5% to 3.5%
• Extends current freeze on participation thresholds for qualification for the APM bonuses for an extra year

Medicaid Rules

• Allow states to start processing Medicaid redeterminations as of April 1, 2023
• Allow states to provide women with Medicaid coverage for 12 months postpartum
• States required to provide children eligible for Medicaid with continuous coverage for a year
• Children’s Health Insurance Program funding extended through 2029
• One-year delay of pending payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under Protecting Access to Medicare Act

 Residency Positions

• 200 new Medicare-supported Graduate Medical Education (GME) residency slots added
• Designed to help ease physician shortage

Mental Health

• An exception to the Stark law to allow hospitals and other entities to provide evidence-based programs to boost physician resiliency and mental health
• Allows marriage and family therapists to receive payment from Medicare for providing covered mental health services to Medicare beneficiaries starting in 2024
• Provides coverage of intensive outpatient services starting in 2024
• 50% payment increase in Medicare Physician Fee Schedule payment rates for crisis psychotherapy services via mobile units starting in 2024
• HHS is now required to conduct outreach to physicians and other healthcare providers on the availability of behavioral health integration services

Opioids

• Removes X-Waiver used by practitioners to prescribe medications like buprenorphine for the treatment of Opioid Use disorder
• Removes limits or patient caps impacting the number of patients a doctor may treat with buprenorphine for OUD.
• Trains pharmacists on patient identification verification when dispensing opioids

Hospital-at-Home

• Extends the Acute Hospital Care at Home initiative through December 31, 2024

We know that’s a lot of information to digest. Now is the perfect time to reach out to our consulting staff to learn more about how these policies affect your bottom line and how our team can help you with financial management.