Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Proposed fee schedule for 2019 could cut EHR hours

A proposed rule, released by the Centers for Medicare & Medicaid Services online July 12 and scheduled for publication July 27 in the Federal Register, would condense all four levels of E&M coding to one level, with one payment. There would no longer be higher payments provided for high levels.

While the change could reduce payments to specialists who generally bill only at the highest level for E&M visits, that difference should be made up in the additional time physicians should have to see patients, according to a fact sheet on the proposed physician fee schedule.

“We estimate that this proposal would save approximately 51 hours of clinic time per clinician per year,” CMS Administrator Seema Verma said during a July 12 press conference, allowing f or an additional 500 years of time available for patient care across the system.

The proposed schedule also would expand the list of services that qualify for telemedicine payments and would add payments for virtual check-ins via phone or other communication technologies such as Skype, paying clinicians for time spent reviewing patient photos submitted via text or e-mail.

This Week's Must Reads

Case studies shed light on treatment for rare form of MCL , Mori S et al. Clin Lymphoma Myeloma Leuk. 2019 Feb;19(2):e93-7.

Histopathological clues for differentiating follicular lymphomas, Servitje O et al. J Cutan Pathol. 2019;46:182-9.

Single agent daratumumab is not an option in B-cell lymphomas, Salles G et al. Clin Lymphoma Myeloma Leuk. 2019 Jan 2. doi: 10.1016/j.clml.2018.12.013.

Ibrutinib combo advances in CNS lymphoma, Grommes C et al. Blood. 2019;133(5):436-45.

Best frontline options for advanced follicular lymphoma, Shah NN et al. Clin Lymphoma Myeloma Leuk. 2019 Feb;19(2):95-102.

Must Reads in Practice Management

No difference in financial distress with counseling intervention , Kircher SM et al. J Oncol Pract. 2019 Jan 9. doi: 10.1200/JOP.18.00270.

Many believe tumor profiling will benefit present treatment, Marron et al. JCO Precis Oncol. 2019 Jan 22. doi: 10.1200/PO.18.00176.

Physician mothers with extra caregiving at home at higher risk, Yank V et al. JAMA Internal Medicine. 2018 Jan 28. doi: 10.1001/jamainternmed.2018.6411.

Over half of Americans support Medicare for All, Kaiser Family Foundation Health Tracking Poll – January 2019