Author | Lightnews

Rob Blaser

Rob Blaser

@robertblaser.bsky.social

950 followers 400 following 110 posts

Health policy analyst focusing on kidney care delivery issues, competent home cook, DC area sports fan. He/him. #NephSky

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Rob Blaser @robertblaser.bsky.social · 7d

The MLN post ended up being correct, CMS issued a clarification last night that aligned with the MLN post and thus the vast majority of claims will be paid as scheduled.

Rob Blaser @robertblaser.bsky.social · 7d

Great question. There was much communication (confusion?) yesterday that all payments were paused per a CMS announcement, but the original Medicare Learning Network (MLN) post said it only claims for expiring provisions were being held, like those for telehealth. (1)

Rob Blaser @robertblaser.bsky.social · 8d

Very kind Charlotte, thank you. Great seeing you and I hope you had an uneventful trip home.

Rob Blaser @robertblaser.bsky.social · 13d

@rpanephrology leaders strategizing about RPA’s Capitol Hill Day tomorrow. Over drinks.

Rob Blaser @robertblaser.bsky.social · 28d

So, given the good chance that a Medicare extenders package happens before say year's end, the flexibilities should be extended then. Stay tuned. (4/end)

Rob Blaser @robertblaser.bsky.social · 28d

Whether that lasts for days/weeks/months no one knows, but practices should be adjusting their schedules accordingly. The positive news IMO is that everyone on the Hill seems to agree that the telehealth flexibilities should be extended if not made permanent. (3)

Rob Blaser @robertblaser.bsky.social · 28d

While I was pretty bullish that this would get resolved prior to 9/30 earlier this year, now it looks pretty likely that there will be a lapse in the flexibilities with an almost certain government shutdown. (2)

Rob Blaser @robertblaser.bsky.social · 28d

Folks, there is a lot of chatter among nephrology practices about whether the telehealth flexibilities and thus the ability to provide services via those means will end on September 30. (1)

Rob Blaser @robertblaser.bsky.social · 28d

Charlotte, the chances of it getting resolved by September 30 are slim to nonexistent. My guess is the flexibilities will be extended by years’ end but when that happens, who knows?

Rob Blaser @robertblaser.bsky.social · Sep 18

NEPHROLOGY NURSES, YOU ROCK!!! Happy Nephrology Nurses Week to all of the heroes out there providing great care to persons with kidney disease, can't wait to spend time with our friends at the American Nephrology Nurses Association next week. Thanks for everything y'all do!

Reposted by Rob Blaser

Jason Kander @jasonkander.bsky.social · Jul 23

You know that scene in an action movie when the bad guy runs through the kitchen of a restaurant and pulls down all the pots and pans behind him to slow down his pursuers? We're in that part of the Trump presidency.

Rob Blaser @robertblaser.bsky.social · Jul 18

Folks, there was a error in my MFS post this A.M., the 'all others' CF increase for 2026 will be about $3.30, not $3.62. The 2nd figure ($3.62) was from the CMS Newsroom press release on the rule, but that's no excuse, I should have double checked the math. Sorry about that.

Rob Blaser @robertblaser.bsky.social · Jul 18

Comments on the proposed rule are due on September 12. (12/end).

Rob Blaser @robertblaser.bsky.social · Jul 18

creation of a new payment model focused on heart failure and low back pain, a change to the Medicare Diabetes Prevention Program to facilitate greater access to the program, and an effort to reduce Medicare spending on skin substitutes, among others. (11)

Rob Blaser @robertblaser.bsky.social · Jul 18

Those are the foundational changes this year, there are of course numerous other proposals (it's an 1800 page rule), on telehealth (but not about extension of the current flexibilities, Congress has to do that), (10)

Rob Blaser @robertblaser.bsky.social · Jul 18

On a code-specific level, CPT code 90935 (hemodialysis, single evaluation), is slated for a 9.4% cut, while the four visit adult outpatient dialysis capitated service (CPT code 90960) is set for a 9.0% increase. (9)

Rob Blaser @robertblaser.bsky.social · Jul 18

Using nephrology as an example of the impact of the RVU changes, while the specialty nets out at a +1% overall impact, on the inpatient side there is a projected 9% payment cut, while outpatient are expected to increase by 7%. (8)

Rob Blaser @robertblaser.bsky.social · Jul 18

$33.59 for those qualifying participants in APMs, $33.42 for all others. Recall that the 2025 CF is $32.35, so the 2026 APM-based CF will be a 3.83% increase over the 2025 CF, while the ‘all others’ CF will be increased by 3.62%. (7)

Rob Blaser @robertblaser.bsky.social · Jul 18

Regarding the 2026 CFs, they include a 0.75% increase for APM participants and a 0.25% increase for all others, the 2.5% increase enacted in the One Big Beautiful Bill (H.R. 1) and also an upward budget neutrality adjustment of 0.55%. All of this results in 2026 CFs of: (6)

Rob Blaser @robertblaser.bsky.social · Jul 18

and (2) a reduction of the the allocation of indirect costs for PE RVUs in the facility setting that CMS believes is more reflective of current medical practice. (5)

Rob Blaser @robertblaser.bsky.social · Jul 18

while outpatient services and primary care will see nearly equal increases in value and payment. CMS' changes that are the catalysts for these revisions are (1) use of an efficiency adjustment on work RVUs that reduces the impact of the survey process used to develop RVUs, (4)

Rob Blaser @robertblaser.bsky.social · Jul 18

The other big headline is that due to fundamental methodological changes affecting development and implementation of changes to relative value units (RVUs), inpatient services and many procedures will see steep reductions in value and payment in 2026, (3)

Rob Blaser @robertblaser.bsky.social · Jul 18

and Part B provider reimbursement is adjusted up or down every year); the two CFs are for (1) physicians who are part of Medicare APMs, and (2) for all others. Implementation of two CFs was legislatively mandated and long in the planning, but it is still a major deal. (2)

Rob Blaser @robertblaser.bsky.social · Jul 18

Folks, the proposed rule for the 2026 Medicare Fee Schedule came out on Monday, with two primary headlines. The first is that there are now two conversion factors (CFs--with the conversion factor being the multiplier expressed as a dollar figure through which physician (1)

Reposted by Rob Blaser

Morgan J Freeman @mjfree.bsky.social · Jul 16

I’m gonna post this every day so nobody forgets exactly who Pedophile Trump is and why the Epstein files have suddenly disappeared.