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  • Access and Reimbursement for Infectious Disease Services

    Access and Payments

    Fair and adequate reimbursement for infectious diseases physicians is a key IDSA policy priority. The Society also advocates for access to appropriate treatments for patients with serious infections and for medical liability reform. IDSA’s positions on specific reimbursement and access issues that impact the practice of infectious diseases and Advocacy Alerts to key policy priorities are provided below. 

    Home Infusion Therapy

    IDSA's Efforts in Access and Reimbursement for ID Services

    12/5/2014

    IDSA Jointly Provides Feedback on the National Quality Forum Measure Endorsement Process

    IDSA has joined 31 other organizations to provide comments on the National Quality Forum (NQF) Measure Endorsement Process. The undersigned organizations believe that there are still deficiencies that need to be resolved, specifically around endorsement review timelines, the implementation of updated evaluation criteria, measure testing, and eMeasure requirements.
    10/31/2014

    IDSA Leads Groups in Letter to CMS on Stewardship (PDF)

    IDSA was joined by 33 other organizations in a letter to the Centers for Medicare & Medicaid Services (CMS) advocating that hospitals and long-term care facilities be required to implement an antibiotic stewardship program (ASP) as a Condition of Participation (COP) in Medicare and Medicaid.  CMS is known to be actively considering the proposal.  The recommednation was also made by the President's Council of Advisors on Science and Technology (PCAST) in their recent report on combatting antibiotic-resistant bacteria.
    9/15/2014

    IDSA Jointly Applauds the Introduction of the Ensuring Access to Primary Care for Women & Children Act, S. 2694 (PDF)

    IDSA jointly applauds the efforts of the Ensuring Access to Primary Care for Women & Children Act, S. 2694. This legislation will help ensure Medicaid enrollees have access to vital primary care services delivered by primary care and related subspecialty physicians, by extending current-law payment rates under Medicaid for certain primary care and immunization services to at least the level of Medicare through 2016.
    9/2/2014

    IDSA Comments on Medicare Program Revisions to Proposed Payment Policies under the Physician Fee Schedule for CY 2015 (PDF)

    IDSA provides comments on the CY 2015 Physician Fee Schedule (PFS) proposed rule regarding changes to the code valuation process, Medicare Telehealth Services, Chronic Care Management, the Physician Quality Reporting System (PQRS), the Physician Resource-Use Feedback Program and the Value-Based Payment Modifier (VBM), the Medicare Shared Savings Program (MSSP) and the Physician Compare Website, among other Part B related issues.
    12/11/2013

    IDSA Joins Cognitive Specialties Coalition in Supporting SGR Repeal and Modifications to Draft Legislation (PDF)

    IDSA signed onto a Cognitive Specialties Coalition providing input to the House and Senate committees working on a repeal of the Sustainable Growth Rate (SGR).  The letter expresses general support for a repeal of the SGR and more specifically calls on Congress to:  provide positive payment updates moving forward, adopt a threshold scoring model as opposed to a competitive one, and to include cognitive specialists in measures to encourage chronic care management and practice enhancements.
    11/12/2013

    IDSA Responds to Congressional Draft of SGR Repeal (PDF)

    IDSA wrote in support of the Senate Finance and House Ways and Means Committees' November 2013 discussion draft of a bill to repeal the Sustainable Growth Rate (SGR) and simplify current value-based payment programs.  The letter also called on Congress to consider periodic physician payment increases, as well as provided detailed recommendations on a host of issues in the congressional draft related to quality and assessment.
    11/6/2013

    IDSA Joins Coalition Appeals to CMS to ensure MA Beneficiaries Have Reliable Information When Choosing Health Insurance Options (PDF)

    As part of a collective of numerous state medical associations and national medical societies, IDSA urges the Centers for Medicare & Medicaid Services (CMS) to take immediate action to ensure that Medicare beneficiaries participating in Medicare Advantage (MA) plans have accurate and reliable information to make health insurance elections during the 2014 Open Enrollment period, and to address a lack of MA sponsor transparency on network adequacy.
    9/6/2013

    IDSA Comments on Medicare Program Revisions to Proposed Payment Policies under the Physician Fee Schedule for CY 2014

    IDSA provides comments on the CY 2014 Physician Fee Schedule (PFS) proposed rule regarding misvalued PFS codes, Medicare payments for services rendered in an office vs. facility, site of service data collection, complex chronic care management services, billing of Evaluation and Management Services, Clinical Laboratory Fee Schedule, Physician Compare website, Physician Quality Reporting System (PQRS), and the Value-Based Payment Modifier and Physician Feedback Program.
    12/31/2012

    IDSA Comments on Medicare Program Final Rule Revisions to Payment Policies under Physician Fee Schedule for CY 2013 (PDF)

    IDSA comments on Medicare program revisions to payments policies regarding bundled or episode-of-care payments, primary care and care coordination, physician quality reporting and value-based payment modifier, code-specific issues, and Medicare coverage of hepatitis B vaccine.
    9/4/2012

    IDSA Comments on Medicare Program Revisions to Proposed Payment Policies under the Physician Fee Schedule for CY 2013 (PDF)

    IDSA provides comments on the PFS proposed rule outlines changes to the code valuation process, the Physician Quality Reporting System (PQRS), the Electronic Prescribing (eRx) Incentive Program, the Physician Resource-Use Feedback Program and the Value-Based Payment Modifier (VBPM), the Medicare Shared Savings Program (MSSP), and the Physician Compare Website.
    12/12/2012

    IDSA Comments on the USPSTF Draft Recommendation Statement - Screening for Hepatitis C Virus (HCV) Infections in Adults

    IDSA comments on the United States Preventive Services Task Force (USPSTF) Draft Recommendation Statement on Screening for Hepatitis C Virus Infection in Adults. IDSA requests USPSTF to change the conservative grade of "C" to "B" in order to identify approximately 800,000 new infections and save 121,000 lives.
    10/19/2012

    Comment Letter on RAC Audits of E/M Codes (PDF)

    IDSA joined with members of the Cognitive Specialty Coalition in requesting that CMS rescind its approval of the Recovery Audit Contractor (RAC) program to include audits of evaluation and management (E/M) codes in physician offices.
    12/23/2011

    IDSA Comments on CMS' Conditions of Participation for Medicare Program (PDF)

    IDSA submitted comments to CMS on the proposed rule related to the Medicare & Medicaid Conditions of Participation (CoP).  This letter advocated for inclusion of "Antimicrobial Stewardship Programs" as part of Infection Control requirements outlined in the CoP.  As well, the letter also supported CMS' proposal to expand the use of hospital standing orders in a way that would promote immunization rates.
    12/22/2011

    IDSA Joins Other Specialty Societies and the AMA in Commenting on CMS' Proposed Rule Related to the Medicare Program's CoPs (PDF)

    Specifically, the letter cites concerns with some of the proposed changes to the Conditions of Participation (CoPs) that affect hospital governing boards and medical staffs.
    12/1/2011

    IDSA Joins Other Cognitive Specialty Groups to Raise Concerns over Medicare Sustainable Growth Rate (SGR) Proposal (PDF)

    IDSA and other groups whose physicians primarily provide "evaluation and management" services expressed concern with a proposal to address the Medicare SGR that includes a modest payment increase for primary care physicians defined to exclude cognitive specialists who primarily bill "evaluation and management services"--using the same codes and providing the same services as primary care physicians.
    11/10/2011

    Physician Groups Continue to Press for SGR Repeal (PDF)

    IDSA joined the American Medical Association and other physician groups on another letter to continue urging the Joint Select Committee on Deficit Reduction to repeal the flawed medicare Sustainable Growth Rate (SGR) formula as part of their legislation to be considered by Congress by the end of the year.

 

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