On July 29, 2019, the Centers for Medicare & Medicaid Services (CMS) released the FY 2020 Medicare Physician Fee Schedule (MPFS) proposed rule [CMS-1715-P] (Proposed Rule). A link to the full rule is available here....more
On April 22, 2019, the Centers for Medicare and Medicaid Services (“CMS”) announced four new voluntary payment models that could allow primary care practitioners like physicians or advanced practice nurses, hospitals or other...more
In the 2019 Medicare Physician Fee Schedule (MPFS) final rule published on November 23, CMS published new policies for accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP). ...more
On November 2, 2017, the Centers for Medicare and Medicaid Services (CMS) released the 2018 Quality Payment Program (QPP) Final Rule. The Final Rule contains notable changes that may affect smaller practices participating in...more
The Center for Medicare & Medicaid Innovation (CMMI) is seeking ideas on how to better drive change and reduce regulatory burden. CMMI solicited ideas to shape the agency’s future activities through a September 2017 “request...more
The Centers for Medicare & Medicaid Services (CMS) recently released its final rule with comment period implementing the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Among its numerous changes,...more
11/9/2016
/ Alternative Payment Models (APM) ,
CEHRT ,
Centers for Medicare & Medicaid Services (CMS) ,
Health Care Providers ,
Healthcare ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
MIPS ,
Physician Medicare Reimbursements ,
Physicians ,
PQRS ,
Quality Payment Program (QPP) ,
Sustainable Growth Rate (SGR)
Many observers view the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as a game changer for the delivery and payment of health care services.
On Oct. 14, 2016 the Centers for Medicare & Medicaid Services...more
11/2/2016
/ ACOs ,
Alternative Payment Models (APM) ,
CEHRT ,
Centers for Medicare & Medicaid Services (CMS) ,
Electronic Health Record Incentives ,
Health Care Providers ,
Healthcare ,
Medicaid ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
MIPS ,
Physician Medicare Reimbursements ,
Physicians ,
PQRS ,
Quality Payment Program (QPP)
On Oct. 14, the Centers for Medicare & Medicaid Services (CMS) published a final rule with comment period implementing the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The nearly 2,400 pages of...more
11/1/2016
/ ACOs ,
Alternative Payment Models (APM) ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Electronic Health Record Incentives ,
Fee-for-Service ,
Final Rules ,
Health Care Providers ,
Healthcare ,
Meaningful Use ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Medicare Part B ,
Medicare Shared Savings Program ,
MIPS ,
Physician Medicare Reimbursements ,
Physicians ,
PQRS ,
Quality Payment Program (QPP) ,
Sustainable Growth Rate (SGR)
On May 9, 2016, the Centers for Medicare & Medicaid Services (CMS) published a notice of proposed rulemaking to implement the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Although the...more
On April 27, 2016, the Centers for Medicare & Medicaid Services (CMS) posted a pre-publication version of a proposed rule implementing changes to Medicare payment for physician services authorized under the bipartisan...more
5/2/2016
/ Alternative Payment Models (APM) ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Electronic Health Record Incentives ,
Fee-for-Service ,
Health Care Providers ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
MIPS ,
Physicians ,
PQRS
The Department of Justice announced on October 16, 2015 a settlement agreement with Tuomey Healthcare System that resolves a $237 million judgment against the system involving claims submitted to the Medicare program in...more
On September 28, 2015, the Centers for Medicare & Medicaid Services (CMS) published a Request for Information (RFI) seeking stakeholder comments related to innovative physician payment models required by the Medicare Access...more
10/1/2015
/ Alternative Payment Models (APM) ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
EHR ,
Electronic Health Record Incentives ,
Health Care Providers ,
Healthcare ,
Hospitals ,
Medicaid ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
MIPS ,
Physician Payments ,
Physicians ,
PQRS ,
Request For Information ,
Value-Based Payments
In This Issue:
- ACO Eligibility Requirements
- Establishing and Maintaining the ACO Participation Agreement
- Data Sharing and Assignment of Beneficiaries
- Shared Savings and Losses
- Waivers of...more
7/7/2015
/ ACO Participant Agreements ,
ACOs ,
Centers for Medicare & Medicaid Services (CMS) ,
Data-Sharing ,
Electronic Health Record Incentives ,
Healthcare ,
Medicaid ,
Medicare ,
Medicare Shared Savings Program ,
Skilled Nursing Facility ,
SNF
In This Issue:
- Top News
..CMS Releases Payment Rules for the Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System, Renal Dialysis and Home Health
..President Signs the Drug Quality...more
In This Issue:
- OMB Directs Department Heads to Prepare for Sequestration
- HHS Finalizes Omnibus HIPAA Rule, Enhances Privacy Requirements
- SCOTUS Says Equitable Tolling Not a Factor in DSH Case
- Report...more
1/25/2013
/ Data Protection ,
DSH ,
Equitable Tolling ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Omnibus Rule ,
HITECH Act ,
Hospitals ,
Medicaid ,
Medicare ,
OMB ,
Pay-For-Delay ,
Pharmaceutical Industry ,
SCOTUS ,
Sequestration
In This Issue:
- Fiscal Cliff Deal Lengthens Medicare Overpayment Recovery Period
- Cutting Medicaid Provider Tax May Shift Costs to States, CRS Finds
- MedPAC Finalizes Payment Recommendations, GAO Solicits...more
1/18/2013
/ American Taxpayer Relief Act ,
Centers for Disease Control and Prevention (CDC) ,
Centers for Medicare & Medicaid Services (CMS) ,
Fiscal Cliff ,
GAO ,
Medicaid ,
Medicare ,
MedPAC ,
OIG ,
Overpayment ,
SMART
In This Issue:
- CMS Releases FY 2012 Financial Report; Misses Target forReductions in Improper Payments
- CMS Releases Guidance on Medicaid/CHIP Issues
- HHS Secretary Extends Deadline for Decision on...more