News & Analysis as of

Physicians Centers for Medicare & Medicaid Services (CMS) Alternative Payment Models (APM)

McDermott+

The MIPS Effect: A Surprise Twist in Estimating Medicare Payments for Clinicians Next Year

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As physician groups and other stakeholders work to finalize comment letters on the calendar year (CY) 2024 Physician Fee Schedule (PFS) proposed regulation by September 11, 2023, the Centers for Medicare & Medicaid Services...more

McDermott Will & Emery

CY 2023 Physician Fee Schedule Proposed Rule

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On July 7, 2022, the Centers for Medicare & Medicaid Services (CMS) released the CY 2023 Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Medicare Part B Proposed Rule, which was published...more

Holland & Knight LLP

CMS Issues 2023 Medicare Physician Fee Schedule Proposed Rule

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The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2023 Medicare Physician Fee Schedule (PFS) Proposed Rule on July 7, 2022, which impacts Medicare Part B payments starting Jan. 1,...more

Manatt, Phelps & Phillips, LLP

[Webinar] Levers of Change: Remapping the Health Care Landscape - March 9th, 1:00 pm - 2:00 pm ET

President Biden set an ambitious health care agenda in his campaign and maintained that focus as he took office. The Biden administration has expressed a strong commitment to “protect and build on the Affordable Care Act,...more

K&L Gates LLP

COVID-19: K&L Gates Triage: Alternative Payment Models: Tied to an Improved COVID-19 Response?

K&L Gates LLP on

In this week's episode, Gabe Scott and Steve Pine discuss recent data showing how health systems participating in Alternative Payment Models compare to other health systems in responding to the COVID-19 crisis, and discuss...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

Global and Professional Options Direct Contracting Model RFA and LOI Now Active

On April 21, 2019, the Center for Medicare and Medicaid Innovation (“CMMI”) announced the CMS Primary Cares Initiative – a voluntary, risk-based initiative to transform the Medicare program’s reimbursement of primary care...more

Holland & Knight LLP

CMS Issues 2020 MPFS and QPP Final Rule

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The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2019, published the Calendar Year (CY) 2020 Final Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS dictates Medicare rates and policies under Part B,...more

K&L Gates LLP

K&L Gates Triage: Quality Payment Program Updates in the CY2020 Physician Fee Schedule Proposed Rule - Part 3

K&L Gates LLP on

In this week’s episode, Steve Pine presents the last installment of our three part series addressing the CMS Quality Payment Program (QPP) updates in the CY2020 Physician Fee Schedule (PFS) Proposed Rule. In this episode, Mr....more

Holland & Knight LLP

CMS Releases 2020 MPFS and QPP Proposed Rule

Holland & Knight LLP on

• The Centers for Medicare & Medicaid Services (CMS) published the Calendar Year (CY) 2020 Proposed Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS dictates Medicare rates and policies under Part B, while the...more

Holland & Knight LLP

Medicare Unveils New Voluntary Primary Care Models

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The Centers for Medicare & Medicaid Services (CMS) announced five new, voluntary value-based payment models for primary care: Primary Care First and Direct Contracting. Applications are expected to open shortly, and both...more

Dorsey & Whitney LLP

CMS’s New “Primary Cares Initiative” Places Primary Care at the Center of the Shift to Value-Based Care

Dorsey & Whitney LLP on

On April 22, 2019, the Centers for Medicare and Medicaid Services (CMS) announced two sweeping new payment innovation models under the Primary Cares Initiatives. The models will seek to incentivize primary care and other...more

Holland & Knight LLP

CMS Releases the 2019 MPFS and QPP Final Rules

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• The Centers for Medicare & Medicaid Services (CMS) has published the Calendar Year (CY) 2019 Final Rule for the Medicare Physician Fee Schedule (PFS), which includes provisions related to Medicare physician payments as well...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

Arnall Golden Gregory LLP

CMS Miscalculates 2019 MIPS Payment Adjustments / Extends MIPS Targeted Review Request Deadline 15 Days

On September 13, 2018, in an update entitled “CMS Updates 2017 MIPS Performance Feedback,” the Centers for Medicare and Medicaid Services (CMS) disclosed that it made errors in the scoring logic used for the merit-based...more

Bass, Berry & Sims PLC

Sprinting to Coordinated Care: Healthcare Industry Urges Stark Law Relief as OIG Solicits Feedback on Changes to the Anti-Kickback...

August 24, 2018 marked a busy day for the U.S. Department of Health & Human Services' (HHS) self-designated "Regulatory Sprint to Coordinated Care," an initiative aimed at dismantling the regulatory barriers to providers...more

Foley & Lardner LLP

Proposed Overhaul to the Medicare Shared Savings Program Would Mean More Risk for ACOs

Foley & Lardner LLP on

On August 9, 2018, CMS introduced a proposed rule that would substantially overhaul the Medicare Shared Savings Program (MSSP), requiring Accountable Care Organizations (ACOs) that participate in the MSSP to accept some...more

Miles & Stockbridge P.C.

The Maryland Primary Care Program – An Important Financial Opportunity for Maryland Physicians

The Maryland Primary Care Program (“MDPCP”) is an unprecedented opportunity for certain health care providers and supporting entities to receive compensation for their efforts to coordinate care and reduce potentially...more

Baker Donelson

QPP Year 3 – CMS Continues Implementation with Proposed Changes

Baker Donelson on

On July 12, 2018, CMS issued proposed revisions to Year 3 of the Quality Payment Program (QPP) in the rule entitled Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2019;...more

Holland & Knight LLP

CMS Issues Proposed Rule on Medicare Physician Payment in 2019

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The Centers for Medicare & Medicaid Services (CMS) on July 12, 2018, published the CY 2019 Proposed Rule for the Medicare Physician Fee Schedule (PFS). While in previous years regulations for the Quality Payment Program (QPP)...more

Mintz - Health Care Viewpoints

CMS Focuses on a Modern Medicare

Earlier this month, CMS proposed changes to the Medicare Physician Fee Schedule and Quality Payment Program with the goal of “modernizing Medicare and restoring the doctor-patient relationship.” The proposed changes achieve...more

Chambliss, Bahner & Stophel, P.C.

CMS Request for Information – Stark Law

CMS is seeking input on ways to reduce the regulatory burdens of the physician self-referral law (commonly known as the Stark Law), particularly as it relates to the ongoing effort to transition from a fee-for-service to a...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

Holland & Knight LLP

CMS Seeks Stakeholder Input on Easing Stark Law Requirements

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• In order to encourage value-based reimbursement and care delivery, the Centers for Medicare & Medicaid Services (CMS) has published a Request for Information (RFI) seeking public input on how to address any undue regulatory...more

Bradley Arant Boult Cummings LLP

CMS Releases Innovation Center New Direction RFI Feedback and Issues New RFI for Direct Provider Contracting

Last fall, the Centers for Medicare & Medicaid Services (CMS) announced a new direction for its Center for Medicare & Medicaid Innovation, CMS’s platform for testing innovative models for delivering high-quality care at lower...more

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