Physicians' Resources

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

Filter By
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....

Policy Snapshot
May 16, 2019

The Centers for Medicare & Medicaid Services (CMS) posted the Electronic Clinical Quality Measure (eCQM) specifications for the 2020 reporting period for eligible hospitals and critical access hospitals and 2020 performance period for ...

Policy Snapshot
May 16, 2019

This week a bipartisan group of senators introduced a piece of legislation to help end surprise medical billing. The STOP Surprise Medical Bills Act calls for an arbitration process for settling disputes between providers and insurers. Under the bill, arbitration would be an option providers and insurers could use if they are unhappy with the payment they receive as a result of out-of-network services. The Senate bill would ensure that a patient only pays in-network cost-sharing rates for emergency services and would protect patients who are taken to out-of-network facilities in...

Spotlight
May 15, 2019

MEMBERS ONLY CONTENT

Login or Join

AMDA On-The-Go podcast host Wayne Saltsman, MD, PhD, CMD, asked some tough questions at the beginning of his April 29 show on Appropriate Use of Antipsychotics in LTC Facilities. Specifically, “In the ever-swinging pendulum of health care, where are we now with regard to antipsychotic medication? Is it useful ‘off label...