Latest federal action on opioid crisis, Senators release bipartisan bill
A bipartisan group of eight senators Tuesday introduced a bill to address the opioid epidemic, which follows up on the Comprehensive Addiction and Recovery Act passed in 2016.
Dubbed CARA 2.0., the bill includes policy changes and increases funding. Among the changes the bill would make include the establishment of a three-day prescribing limit on opioids for acute pain, a requirement that physicians and pharmacists use their state prescription drug monitoring program before prescribing or dispensing opioids and a provision to let states waive the cap on the number of patients a physician can prescribe buprenorphine to treat opioid addiction.
Additionally, top Republicans and Democrats on the House Ways and Means Committee are working to craft legislation to prevent and treat opioid addiction in Medicare. The lawmakers are asking insurers, benefit managers, providers and prescribers to submit information on how the Medicare program can help stem the opioid epidemic. (Legislation, The Hill)
U.S. doctors told to screen adolescents for depression every year
The American Academy of Pediatrics released new guidelines this week calling for doctors to screen all children 12 years and older for depression annually at their health maintenance visits.
The pediatrics group said as many as 1 in 5 teens experience depression at some point during adolescence, but often go undiagnosed and untreated. Recognizing that pediatricians and other primary care providers are often in the best position to identify and help struggling teens, the AAP published updated medical guidelines on adolescent depression. It’s the first update to the guidelines in 10 years. (AAP guidelines)
Researchers urge Congress to replace MIPS
Writing in a Health Affairs blog post, a group of six researchers added their voices to the call to replace Medicare’s Merit-based Incentive Payment System (MIPS).
While the first year under MIPS just ended, some observers, including the Medicare Payment Advisory Commission (MedPAC), have called for the government to abandon MIPS. The researchers agreed and outlined their argument for why Congress should repeal MIPS and replace it with stronger incentives for physicians to participate in advanced alternative payment models and targeted incentives for certain well-defined activities currently encouraged under MIPS. (Health Affairs blog post)
Physicians and payers need to work to improve network directories
A physician survey reveals the need for physicians and health plans to work together to ensure better accuracy in network directories.
The survey, released by the American Medical Association and LexisNexis Risk Solutions, found more than half of U.S. physicians (52%) said they encounter patients every month with health insurance coverage issues because of inaccurate directories of in-network doctors. Problems occur when patients rely on outdated, inaccurate or incomplete directory data to locate an in-network physician. (AMA announcement)
Hospital, physician advocacy groups press Anthem for further changes to controversial policies
Major physician and hospital advocacy groups say Anthem’s decision to repeal its planned “modifier 25” policy does not go far enough to address their concerns over recent changes in coverage policies.
The American Hospital Association joined the American College of Radiology and the American College of Emergency Physicians to urge the insurer to rescind a set of coverage policies regarding emergency care and outpatient imaging. FierceHealthcare received an emailed copy of the organizations' Feb. 27 letter to Craig Samitt, M.D., Anthem’s executive vice president and chief clinical officer.
Anthem announced last year new policies that aimed to deny coverage for ER visits that do not end up qualifying as emergencies and to steer patients toward freestanding imaging centers rather than hospitals for radiology service. Providers have strongly opposed the changes. In recent weeks, the insurer has altered its ER coverage policies and announced its plan to drop its policy that would have reduced payments for evaluation and management codes reported with CPT modifier 25. (Fierce Healthcare)