Wednesday, July 10, 2024

CMS Releases Physician Proposed Rule CY2025

 On July 10, 2024, CMS released the inspection copy of the CY2025 proposed rule for physician services.  The Federal Register version will appear July 31.

The typescript version weighs in at 2248 pages.

Barring Congressional action, there would be a 2.9% physician payment cut due to budget neutrality laws.   Discussion at Advisory Board.


CLFS No News

There's a section for updated CLFS regulations, but it appears to be limited to routine updates to PAMA based on past Congressional line items.  Page 581-591.

Colorectal Updates

Section K, 1127-1145, discusses expanding rules for colorectal cancer screening.   CMS proposes to update regulations at 42 CFR 410.37 to delete barium enema, add computed tomography colonograph (CTC), and to define "a complete screening" to include both a blood-based biomarker test AND the subsequent screening colonoscopy.   (A complete screen is already so defined after stool-based biomarker).

Why the CRC changes? Barium enema coverage has been in place since 1998.  CMS can't delete sigmoidoscopy coverage, because it's named in statute.   Addition of CTC (colonography) is related to its positioning now in accepted screening guidelines.  

Software and AI

I don't see much about software or AI this year, although there is a section on digital mental health treatment at 377ff.  (Covered by Fierce Healthcare here).  See also some telemedicine changes (here).  See coverage at STAT here.