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Health Policy
July 12, 2019

SNF PPS Patient Driven Payment Model: Get Ready for Implementation on October 1

On October 1, the new Patient Driven Payment Model (PDPM) is replacing the Resource Utilization Group, Version IV for the Skilled Nursing Facility (SNF) Prospective Payment System (PPS). CMS has resources to help you prepare:

Health Policy
July 3, 2019

The Centers for Medicare & Medicaid Services (CMS) updated its Quality Payment Program Participation Status Tool based on the first snapshot of data from Alternative Payment Model (APM)...

Health Policy
July 3, 2019

As of July 1, 2019, the 2020 Merit-Based Incentive Payment System (MIPS) Self-Nomination Period for Qualified Clinical Data Registries (QCDRs) and Qualified Registries is now open. Qualified Registries and QCDRs are Centers for Medicare & Medicaid Services (CMS)-approved vendors that collect clinical data on behalf of clinicians for data submission. Please note that eligible clinicians wishing to report for the 2020 MIPS performance period via the Qualified Registry or QCDR reporting mechanism do NOT need to self-nominate. Only entities wishing to participate (and who meet the...

Health Policy
June 27, 2019

Last week the House Ways & Means Committee passed five Medicare-related bills, including legislation to expand coverage of telehealth services for mental health treatment, eliminate beneficiary cost-sharing for chronic care management services, and add 1,000 new residency slots under the Graduate Medical Education program. Here are some additional specifics:

  • H.R. 3414, the Opioid Workforce Act, would fund 1,000 new residency GME positions in the areas of addiction medicine and psychiatry over the next six years.
  • H.R. 3417, the BETTER Act, was approved
  • ...
Health Policy
June 27, 2019

The Centers for Medicare & Medicaid Services (CMS) deadline to submit Promoting Interoperability Measures and Improvement Activities for consideration for future years of the Merit-based Incentive Payment System (MIPS) is Monday, July 1.

The MIPS Annual Call for Measures and Activities process allows clinicians, professional associations, and medical societies that represent clinicians, researchers, consumer groups, and others to identify and submit measures and activities. CMS currently is accepting submissions for:  

  • EHR measures for the
  • ...
Health Policy
June 27, 2019

The Centers for Medicare & Medicaid Services (CMS) contracted with Guidehouse to conduct data validation and audits of some Merit-based Incentive Payment System (MIPS) eligible clinicians. Data validation and audits will help ensure MIPS is operating with accurate and useful data. MIPS-eligible clinicians, groups, and virtual groups are required by ...

Health Policy
June 21, 2019

On June 17, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule  that would update the Part D e-prescribing program by adopting standards that ensure secure transmissions and expedite prior authorizations.

Under the proposed change, clinicians would be able to choose to complete prior authorizations online, reducing burden for...

Health Policy
June 21, 2019

The Centers for Medicare & Medicaid Services (CMS) is accepting Notices of Intent to Apply (NOIAs) via the Accountable Care Organization Management System (ACO-MS) for a January 1, 2020, start date. You must submit a NOIA if you intend to apply to the BASIC or ENHANCED track of the Medicare Shared Savings Program, for a Skilled Nursing Facility (SNF) 3-Day Rule Waiver, and/or to establish and operate a Beneficiary Incentive Program:

  • NOIA submissions are due no later than June 28 at noon ET
  • A NOIA submission does
  • ...
Health Policy
June 21, 2019

The Centers for Medicare & Medicaid Services (CMS) has contracted with Guidehouse to conduct data validation and audits of a select number of Merit-based Incentive Payment System (MIPS) eligible clinicians.  Data validation and audits are processes that will help ensure MIPS is operating with accurate and useful data. MIPS-eligible clinicians, groups, and virtual groups are required by regulation to comply with data-sharing requests, providing all data as requested by CMS.

If you are selected for data validation and/or audit, you will receive a request for information from...

Health Policy
June 14, 2019

Last week, first-time Society delegates Wayne Saltsman, MD, PhD, CMD, and Walter Lin, MD, MBA, attended the American Medical Association (AMA) House of Delegates meeting in Chicago, IL. The Society tracked and reviewed hundreds of resolutions submitted by state and specialty societies dealing with a variety of top policy issues. While the Society did not submit any resolutions for this year’s meeting, there were many that we monitored closely.

The American Association Geriatric Physiatry (AAGP) introduced resolution 708, “Access to Psychiatric Treatment in Long-Term Care.” The...