News & Analysis as of

Alternative Payment Models (APM) Medicare Access and CHIP Reauthorization (MACRA)

McDermott+

House Holds Hearing on MACRA Challenges, but Meaningful Reform is Unlikely

McDermott+ on

On June 22, 2023, the US House of Representatives Committee on Energy and Commerce Subcommittee on Oversight and Investigations held a hearing titled “MACRA Checkup: Assessing Implementation and Challenges that Remain for...more

King & Spalding

CMS Announces CMMI Milestones and Updates

King & Spalding on

CMS recently announced updates and milestones for several programs run by the Center for Medicare and Medicaid Innovation (CMMI). CMMI is the internal CMS agency responsible for developing and testing new health care payment...more

Sheppard Mullin Richter & Hampton LLP

The Merit-Based Incentive Payment System’s Targeted Review Deadline is Upon Us: Physicians, Groups, and other Clinicians have...

The Centers for Medicare & Medicaid Services (CMS) recently announced that it has several “prevailing concerns” regarding the accuracy of the 2017 Merit-Based Incentive Payment System (MIPS) scoring data that was used to set...more

Bass, Berry & Sims PLC

Stark Under the Microscope: Congress and HHS Examine Reform of the Stark Law for a Value-Based System

Bass, Berry & Sims PLC on

On July 17, 2018, the U.S. House of Representatives' Ways and Means Committee Subcommittee on Health ("Subcommittee") expressed its commitment to modernizing the Stark Law during a hearing in which industry and government...more

Foley & Lardner LLP

New Demonstration Program Would Reward Clinicians for Accepting Risk in Medicare Advantage

Foley & Lardner LLP on

CMS recently announced that it wants to launch a new demonstration program, the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration. If approved and adopted as a demonstration project, the MAQI...more

McDermott Will & Emery

CMS Opens Module for MA Plans to Report MACRA Other Payer Advanced APM Information

The other payer advanced alternative payment model (APM) option is intended to give eligible clinicians an additional option to meet MACRA’s escalating participation thresholds to qualify for the 5 percent advanced APM bonus....more

Foley & Lardner LLP

6 Key Takeaways for Providers on BPCI-Advanced (Value-Based Medicare Payment)

Foley & Lardner LLP on

Despite some initial difficulty in gaining momentum, the use of value-based payment methodologies will likely increase across all provider niches. This change is partly a function of cost savings driven by margin compression...more

Burr & Forman

MACRA: Rolled Out and Still Rolling

Burr & Forman on

Most physicians have, by this point, gained some familiarity with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The name of this law has appeared frequently in commentary over the past several years, and...more

Foley & Lardner LLP

CMS Announces an Advanced Alternative Payment Model - BPCI Advanced

Foley & Lardner LLP on

On January 9, 2018, The Centers for Medicare & Medicaid Services (CMS) announced a new voluntary bundled payment model program – Bundled Payment for Care Improvement Advanced (BPCI Advanced). The episode payment model, which...more

Holland & Knight LLP

CMS Proposes New Voluntary Bundled Payment Model

Holland & Knight LLP on

On January 9, the Centers for Medicare and Medicaid Services (CMS) announced a new voluntary bundled-payment demonstration program, also known as Bundled Payments for Care Improvement (BPCI) Advanced. The new model will test...more

Robinson+Cole Health Law Diagnosis

CMS Announces First Advanced Alternative Payment Model Under MACRA: Bundled Payments for Care Improvement Advanced

On January 9, 2018, the Centers for Medicare & Medicaid (CMS) Center for Medicare and Medicaid Innovation announced a new voluntary bundled payment model called Bundled Payments for Care Improvement Advanced (BPCI Advanced). ...more

Bricker Graydon LLP

CMS Quality Payment Program: Are you ready for round two?

Bricker Graydon LLP on

2018 marks the commencement of the second performance year for the Medicare Quality Payment Program (QPP), implemented under the Medicare Access and CHIP Reauthorization Act of 2015 (otherwise known as MACRA). ...more

Baker Donelson

MACRA Final Rule Continues Gradual Transition and Provider Flexibility for 2018

Baker Donelson on

On November 2, the Centers for Medicare and Medicaid Services (CMS) released the final rule implementing policies for Year 2 (2018) of the Quality Payment Program established under the Medicare Access and CHIP Reauthorization...more

Pierce Atwood LLP

“We’re Listening” – CMS Issues Final Rule For Year 2 Of The Quality Payment Program And Highlights Efforts To Continue...

Pierce Atwood LLP on

On November 2, 2017, CMS issued the final rule with comment for the second year (2018) of the Quality Payment Program as well as an interim final rule. Continuing with its theme of a CMS that is “listening to feedback,” CMS...more

Polsinelli

Year 2 in the QPP: A Regulatory Update

Polsinelli on

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

Mintz - Health Care Viewpoints

Health Care Weekly Preview from ML Strategies – November 2017

Following House passage of a CHIP reauthorization package, the bill heads to the Senate where it faces an uncertain path forward. First, there’s no indication the Senate is ready to give the House package real consideration....more

Robinson+Cole Data Privacy + Security Insider

CMS Addresses Lingering Uncertainties and Raises Others via MACRA Information Blocking Guidance

The Centers for Medicare & Medicaid Services (CMS) recently issued guidance intended to help clinicians eligible for the Merit-based Incentive Payment System (MIPS) navigate an attestation required thereunder concerning the...more

Sheppard Mullin Richter & Hampton LLP

MACRA Update: How to Prepare for Changes in MIPS

As we reported last month, CMS’ proposed rule updating MACRA’s Quality Payment Program (“QPP”) for CY 2018 would extend and expand exceptions that would allow many practitioners to avoid participating in its Merit-based...more

Baker Donelson

Final Rule for MACRA's Second Year (2018) Expected in November 2017

Baker Donelson on

On June 20, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule entitled, "Medicare Program; CY 2018 Updates to the Quality Payment Program." CMS proposed changes for the second year (2018) of the...more

Mintz - Health Care Viewpoints

Hospitals and Others Respond to “Red Tape Relief Project” Requests

Last week, a number of health care industry associations sent letters to Congress detailing ways in which the government could relieve them of the burdens associated with “red tape.” The letters are in response to the first...more

Mintz - Health Care Viewpoints

CMS Proposes to Cancel Bundled Payment and Incentive Models

The U.S. Centers for Medicare & Medicaid Services (CMS) published a proposed rule last week regarding the cancellation of three bundled payment models and an incentive payment model while also reducing the scope of a third...more

Sheppard Mullin Richter & Hampton LLP

MACRA Quality Payment Program Update

On June 20, 2017, CMS released its proposed rule updating MACRA’s Quality Payment Program (“QPP”) for CY 2018. At over 1,000 pages, the rule might not do much to simplify the already complex requirements of the QPP; however,...more

Baker Donelson

CMS Proposes QPP Revisions: The Paths for QPP Participation Continue to Evolve

Baker Donelson on

CMS recently proposed modified policies for continued implementation of the Quality Payment Program (QPP) in the 2017 Proposed Rule. Among other things, the Proposed Rule provides flexibility for clinicians in the second QPP...more

BakerHostetler

CMS Proposes CY 2018 Quality Payment Program Policy Changes that Signal Intent to Reduce the Pace and Burdens of MACRA

BakerHostetler on

On June 30, the Centers for Medicare & Medicaid Services (CMS) issued a much anticipated rule outlining proposed payment and policy changes to the new Medicare Part B Quality Payment Program (QPP) that was created by the...more

Arnall Golden Gregory LLP

CMS Issues Proposed Rule to Increase Flexibility and Reduce Burden in the Second Year of MACRA’s Quality Payment Program

On June 20, 2017, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule (CMS-5522-P) that would make changes to the second year requirements of the Medicare Access and CHIP Reauthorization Act of 2015...more

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