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CMS to allow patients to bill physicians directly

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CMS to allow patients to bill physicians directly

CMS to allow patients to bill physicians directly April 25, 2018

The Centers for Medicare & Medicaid Services (CMS) has released comments it received on the CMS Innovation Center’s New Direction Request for Information (RFI) published in the fall of 2017. The intent of the RFI was to “collect ideas on a new direction for the agency’s Innovation Center to promote patient-centered care and test market driven reforms that: empower beneficiaries as consumers, provide price transparency, increase choices and competition to drive quality, reduce costs, and improve outcomes.”

Many of the comments CMS received from healthcare providers “reflected broad support for reducing burdensome requirements and unnecessary regulations.” To that end, CMS has announced that it is taking steps toward developing a direct provider contracting model. Under the new structure, Medicare patients would be able to contract directly with their physicians.

In their announcement, CMS indicated that the new direct provider contract model would drive better beneficiary outcomes by allowing physicians to “take further accountability for the cost and quality of a designated population.” In addition, the model would potentially “enhance the doctor-patient relationship by eliminating administrative burden for clinicians and providing increased flexibility to provide the high-quality care that is most appropriate for their patients, thus improving quality while reducing expenditures.”

CMS Administrator Seema Verma has said that she recognizes that “the best ideas don’t come from Washington, so it’s important that we hear from the front lines of our healthcare system about how we can improve care.”

A follow-up RFI has been issued, to gather detailed information from healthcare providers that will enable CMS to design and release the direct provider contract model. Comments on the recently issued RFI are due by 11:59 EDT on Friday, May 25, 2018. Physicians interested in providing input can find the Direct Provider Contracting RFI at