Physicians' Resources

Your home for news, products, stories, and more specific to physicians practicing in post-acute and long-term care settings. 

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Policy Snapshot
June 7, 2019

In a letter sent this week to congressional leaders, the Society joined the American Medical Association and other national medical societies in urging Congress to make further refinements to improve the Medicare Access and CHIP Reauthorization Act (MACRA). The groups called on Congress to replace the 2020-2025 physician payment update freeze with positive payment adjustments for physicians, extend the Advanced APM bonus payments for an additional six years, and implement several additional technical improvements to MACRA.

MACRA included modest positive payment updates in the...

Policy Snapshot
June 7, 2019

Recently the Centers for Medicare & Medicaid Services (CMS) responded to an inquiry from Sens. Bob Casey (D-PA) and Pat Toomey (R-PA) regarding underperforming nursing homes. CMS sent them a list of nursing homes with a recorded pattern of poor care and the senators released the information to the public along with a report and additional background information.

Under the Special Focus Facility (SFF) program, overseen by CMS, those facilities are made public; however, SFF...

Policy Snapshot
May 30, 2019

The Centers for Disease Control and Prevention (CDC) is raising awareness of the risk to patient health and safety due to misapplication of the opioid guideline for chronic pain.  Please read the recent commentary in the New England Journal of Medicine, where authors of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain advise against misapplication of the guideline that can put patients’ health and safety at ...

Policy Snapshot
May 30, 2019

Recently the Centers for Medicare & Medicaid Services (CMS) released its final rule on Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses. These changes will ensure that patients have greater transparency into the cost of prescription drugs in Part D and will also enable Medicare Advantage plans to negotiate better prices for physician-administered medicines in Part C.

Part D Protected Classes

Current Part D policy requires sponsors to include on their formularies all drugs in six categories or classes...

Policy Snapshot
May 30, 2019

On May 28, the Centers for Medicare & Medicaid Services (CMS) finalized a rule to update and modernize the Programs of All-Inclusive Care for the Elderly (PACE). PACE provides comprehensive medical and social services to certain frail, elderly individuals who qualify for nursing home care but, at the time of enrollment, can still live safely in the community. The majority of participants are dually eligible for both Medicare and Medicaid.

The final rule revises and updates the requirements for the PACE program under Medicare and Medicaid, including:

  • Strengthening
  • ...
Policy Snapshot
May 30, 2019

During a hearing on Protecting Patients from Surprise Medical Bills, the Society—through its membership in the National Observation Stays Coalition—recently urged members of the House Ways and Means Health Subcommittee to take note how surprise billing affects Medicare patients in the hospital who are classified at observation status. “Although the medically necessary care they need and receive is no different from the medically necessary care provided to formally admitted...

Policy Snapshot
May 23, 2019

Beginning this year, all Promoting Interoperability Program participants must use 2015 Edition Certified Electronic Health Record (EHR) Technology (CEHRT) to avoid a downward Medicare payment adjustment. 2019 CEHRT requirements:

  • Did not need to be in place by January 1, 2019, but must be used for the entire EHR reporting period of any continuous, self-selected 90-day period
  • Functionality must be in place by the first day of the EHR reporting period and the product must be certified to the 2015 Edition criteria by the last day of the EHR reporting period
  • ...
Policy Snapshot
May 23, 2019

Skilled Nursing Facility (SNF) Provider Preview Reports are available from the Centers for Medicare & Medicaid Services (CMS). Review your performance data by May 30, prior to public display on Nursing Home Compare in July 2019. Corrections to the underlying data are not permitted during this time; request a CMS review if you believe your data is inaccurate.

For more information:

  • ...
Policy Snapshot
May 23, 2019

Last week, Reps. Jan Schakowsky (D-IL) and Michael C. Burgess (R-TX) introduced the bipartisan EMPOWER for Health Act of 2019 (H.R. 2781) in the U.S. House of Representatives.  The bill reauthorizes many workforce programs under Title VII of the Public Health Service Act, including geriatrics, and would ensure communities across the United States have access to health professionals and other critical supports to improve care for an aging population....

Policy Snapshot
May 16, 2019

During the webinar—which is being held on Thursday, May 23, from 1 to 2 PM ET, CMS experts will provide a brief overview of the Merit-based Incentive Payment System (MIPS) and discuss the following Improvement Activities Performance Category topics:

  • Basics
  • Reporting requirements
  • Data submission
  • Scoring
  • Flexibilities for small and rural practices
  • Resources

Register today....