2021-14973: Medicare Program; CY 2022 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Provider Enrollment Regulation Updates; Provider and Supplier Prepayment and Post-Payment Medical Review Requirements.

Summary

This major proposed rule addresses: Changes to the physician fee schedule (PFS); other changes to Medicare Part B payment policies to ensure that payment systems are updated to reflect changes in medical practice, relative value of services, and changes in the statute; Medicare Shared Savings Program requirements; updates to the Quality Payment Program; Medicare coverage of opioid use disorder services furnished by opioid treatment programs; updates to certain Medicare provider enrollment policies; requirements for prepayment and post-payment medical review activities; requirement for electronic prescribing for controlled substances for a covered Part D drug under a prescription drug plan, or a Medicare Advantage Prescription Drug (MA- PD) plan; updates to the Medicare Ground Ambulance Data Collection System; changes to the Medicare Diabetes Prevention Program (MDPP) expanded model; and amendments to the physician self-referral law regulations.

The agency’s own summary, as published.

What this changes

Amends 9 parts of the Code of Federal Regulations — the standing rules this notice rewrites.

• 42 CFR 403 Special Programs and Projects
• 42 CFR 405 Federal Health Insurance for the Aged and Disabled
• 42 CFR 410 Supplementary Medical Insurance (SMI) Benefits
• 42 CFR 411 Exclusions from Medicare and Limitations on Medicare Payment
• 42 CFR 414 Payment for Part B Medical and Other Health Services
• 42 CFR 415 Services Furnished by Physicians in Providers, Supervising Physicians in Teaching Settings, and Residents in Certain Settings
• 42 CFR 423 Voluntary Medicare Prescription Drug Benefit
• 42 CFR 424 Conditions for Medicare Payment
• 42 CFR 425 Medicare Shared Savings Program