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Policy Snapshot
November 14, 2019

The Centers for Medicare & Medicaid Services (CMS) announced Notice of Intent to Apply (NOIA) and application submission dates for a January 1, 2021, start date for the Medicare Shared Savings Program. Beginning April 20, 2020, CMS will start accepting NOIAs via the Accountable Care Organization (ACO) Management System. You must submit a NOIA if you intend to apply...

Policy Snapshot
November 14, 2019

The Centers for Medicare & Medicaid Services (CMS) invites you to share your perspectives during a listening session on “Modernizing and Clarifying the Physician Self-Referral Regulations Proposed Rule (CMS-1720-P),” which can be found here. The call will be held on Wednesday, November 20, at 4 PM ET....

Policy Snapshot
November 14, 2019

The Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services Administration for Community Living are working with the National Quality Forum (NQF) to design a foundation for measuring performance of person-centered planning across community-based and institutional settings, including:

  • Definition for person-centered planning
  • Core competencies for facilitators
  • Optimal systems characteristics

NQF is accepting comments on the ...

Policy Snapshot
November 14, 2019

The Centers for Medicare & Medicaid Services (CMS) will provide information about the final rule for the 2020 Performance Period of the Quality Payment Program during a webinar on Tuesday, November 19, from 2 to 3:30 PM ET. Topics include:

  • Overview of the Quality Payment Program, Merit-based Incentive Payment System (MIPS), and Advanced Alternative Payment Models (Advanced APMs)
  • MIPS and Advanced APM policy changes
  • Key differences between 2019 and 2020 requirements
  • MIPS Value Pathways, a new participation framework starting in 2021
  • ...
Policy Snapshot
November 7, 2019

On November 1, 2019, the Centers for Medicare & Medicaid Services (CMS) released the CY 2020 Medicare Physician Fee Schedule and Quality Payment Program (QPP) final rules. Below is a summary of some of the policies CMS finalized.

Physician Fee Schedule (PFS)

CY 2020 PFS Conversion Factor

CMS is finalizing a series of standard technical proposals involving practice expense, including implementation of the second year of the market-based supply and equipment pricing update, and standard rate setting refinements to update premium data...

Policy Snapshot
November 7, 2019

As the Centers for Medicare & Medicaid Services (CMS) has undertaken the implementation of the Patient Driven Payment Model (PDPM), it is holding a limited number of Skilled Nursing Facility (SNF) claims while making further refinements to its claims processing system.

Specifically, CMS is holding claims with:

  • Dates of service October 1, 2019, or later
  • Type of Bill (TOB) inpatient services (21X) and swing bed services (18X) subject to the SNF Patient Driven Payment Model (PDPM)
  • Multiple line items, Health Insurance Prospective Payment System (
  • ...
Policy Snapshot
November 7, 2019

In a recent report, the Office of Inspector General (OIG) determined that the Centers for Medicare & Medicaid Services (CMS) improperly paid practitioners for some telehealth claims associated with services that did not meet Medicare requirements. CMS released the Medicare Telehealth Services Video to help you bill correctly. Additional resources:

  • ...
Policy Snapshot
November 1, 2019

Last week the House of Representatives passed legislation—the EMPOWER for Health Act of 2019 (H.R. 2781)—that would reauthorize federal geriatrics workforce programs. The bill was introduced by Reps. Jan Schakowsky (D-IL) and Michael C. Burgess (R-TX); it reauthorizes many workforce programs under Title VII of the Public Health Service Act,...