Case Study 5.27 Gretchen Murphy, an HIM professional, has been asked to participate in a community panel discussion on national healthcare policies as they relate to access, cost, and quality. Her focus will be on cost of care. Gretchen wants to provide information on at least three federal regulations that have had an impact on the cost of healthcare. Select three federal regulations with such an impact and provide a brief synopsis of the key points as they each relate to healthcare cost. Agency: CMS Action: Proposed Rule Summary: Changes to the FFS schedule, relative value of services, Opioid Treatment Programs, and Medicare Shared Savings Program. It is unclear if there is increased cost to first party/ the patient. Another proposed rule of CMS declares that as of January 1, 2021 all opioid prescriptions must transmitted electronically. 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; Medicaid Promoting Interoperability Program requirements for Eligible Professionals; updates to the Quality Payment Program; Medicare coverage of opioid use disorder services furnished by opioid treatment programs; Medicare enrollment of Opioid Treatment Programs; payment for office/outpatient evaluation and management services; Requirement for Electronic Prescribing for Controlled Substances for a Covered Part D drug under a prescription drug plan or an MA-PD plan and Medicare Diabetes Prevention Program (MDPP) expanded model Emergency Policy. Source: https://www.federalregister.gov/documents/2020/08/17/2020-17127/medicare-program-cy- 2021-payment-policies-under-the-physician-fee-schedule-and-other-changes-to-part 2. Agency: CMS Action: Interim final rule with comment period Summary: Medicare has become more accommodating for it's elderly patients. They will cover telemedicine appointment, appointments via phone and internet to help patients stay safe and prevent spreading COVID. This can greatly reduce the expense for patients who normally would have to pay out of pocket for telemed services. This interim final rule with comment period (IFC) gives individuals and entities that provide services to Medicare beneficiaries needed flexibilities to respond effectively to the serious public health threats posed by the spread of the 2019 Novel Coronavirus (COVID-19). Recognizing the urgency of this situation, and understanding that some pre-existing Medicare payment rules may inhibit innovative uses of technology and capacity that might otherwise be effective in the efforts to mitigate the impact of the pandemic on Medicare beneficiaries and the American public, we are changing Medicare payment rules during the Public Health Emergency (PHE) for the COVID-19 pandemic so that physicians and other practitioners, home health and hospice providers, inpatient rehabilitation facilities, rural health clinics (RHCs), and federally qualified health centers (FQHCs) are allowed broad flexibilities to furnish services using remote communications technology to avoid exposure risks to health care providers, patients, and the community. We are also altering the applicable payment policies to provide specimen collection fees