Practice Rounds: HHS to Aid Small Practices with MACRA

HHS is giving $100 million to help small practices implement MACRA over five years; Zika relief funding faces hurdles in Congress.

Welcome to Practice Rounds, our new weekly column exploring what's being covered in the larger world of healthcare.

HHS Helps Small Practices with MACRA

HHS announced it is allocating $20 million over the next five years to educate small practices on complying with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The $100 million will aim to help smaller practices (defined as 15 clinicians or fewer) through organizations that can demonstrate their ability to provide customized training to clinicians. The organizations must not charge any fees to provide this education to the practices, HHS says. According to HHS' own projections, MACRA implementation could have a damaging effect on small practices. In its initial proposed rule, CMS said 87 percent of solo practices will face a negative adjustment in year one of MACRA.

DOJ Cracks Down on Healthcare Fraud

The Department of Justice and HHS announced a major crackdown on healthcare fraud this week. The Medicare Fraud Strike Force made charges in 36 federal districts, resulting in charges against 301 individuals, including 61 doctors, nurses, and other licensed medical professionals. The total amount of medical fraud for the charged individuals involves approximately $900 million in false billings. The crimes included conspiracy to commit healthcare fraud, violations of the anti-kickback statutes, money laundering, and aggravated identity theft. Often, these individuals reportedly provided services and submitted claims for treatments that were medically unnecessary.

Zika Relief Funding Faces Hurdles

It does not seem likely that Congress will pass any bill into law that would aid the fight against the Zika virus before they go on recess. The House Republicans passed a proposed bill for $1.1 billion in relief, but The New York Times reports that much of it is redirected to other programs. As it stands, Democrats in both the House and Senate are unlikely to agree to the proposal. Moreover, President Obama said he would veto such a bill. In February, officials from the Centers for Disease Control (CDC) said that it would take nearly $2 billion to fight the disease, $828 million of which would be for the CDC itself.

Guidelines for Opioid Prescription

Recent guidance from the Centers for Disease Control on how to prescribe opioid medication for chronic pain is not as big of a deal as some physicians believe. For one thing, Psychiatric Times says that while it's been reported as a new checklist, the guideline is purely voluntary. Another misconception is that it's for all types of pain patients, when it's just for those with chronic pain. It does not apply to patients who are "being treated for cancer or who are receiving end-of-life or palliative care." The guideline contains 12 specific recommendations. To read more, click here.

Quote of the Week:

Making the Case for Direct Primary Care

"Many of us have been born into a country where we think health insurance means healthcare. Health insurance is not in the business of healthcare, it's in the business of insurance."

M. Samir Qamar, family physician for a direct primary care group practice