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Quality Payment Program: Participation Status Tool Includes Second Snapshot of Data

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Payment, Alternative Payment Models (APM), Merit-Based Incentive Program Payment System (MIPS), Practice Management, Practitioners
October 17, 2019

The Centers for Medicare & Medicaid Services (CMS) updated the Quality Payment Program Participation Status Tool based on the second snapshot of data from Alternative Payment Model (APM) entities. The second snapshot includes data from Medicare Part B claims with dates of service between January 1 and June...

Quality Payment Program: MIPS and APM Resources from CMS

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Alternative Payment Models (APM), Medicare Access and CHIP Re-authorization Act (MACRA), Merit-Based Incentive Program Payment System (MIPS), Quality Payment Program (QPP), Practice Management, Practitioners
October 17, 2019

The Centers for Medicare & Medicare Services (CMS) posted new Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) resources:

MIPS 2018 Performance Period Resources:

CMS and OIG Propose Stark Law and Anti-Kickback Statute Reforms

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Federal Regulations, Practitioners
October 10, 2019

This week, the Department of Health and Human Services (HHS) announced proposed changes, by the Centers for Medicare & Medicaid Services (CMS) and the Office of the Inspector General (OIG), to modernize and clarify the regulations that interpret the Physician Self-Referral Law (the “Stark Law”) and the Federal Anti-Kickback Statute.

The proposed rules are aimed at providing greater certainty for health care providers participating in value-based arrangements and providing coordinated care for patients. The proposals would ease the compliance burden for health care providers...

CMS Issues Changes to Nursing Home Compare to Focus on Abuse and Neglect

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Quality, Resident
October 10, 2019

On October 7, the Centers for Medicare & Medicaid Services (CMS) announced a major change of the information available to nursing home residents, families, and caregivers on the Nursing Home Compare website. Beginning October 23, CMS will display a consumer alert icon next to nursing homes that have been cited for incidents of abuse, neglect, or exploitation.

The new alert icon will be added for facilities cited on inspection reports for one or both of the following:

  • Abuse that led to harm
    • ...

Register for CMS’ October 16 MIPS Eligible Measures Applicability Process Webinar

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Medicare Access and CHIP Re-authorization Act (MACRA), Merit-Based Incentive Program Payment System (MIPS), Quality Payment Program (QPP), Practice Management, Practitioners
October 10, 2019

The Centers for Medicare & Medicaid Services (CMS) is hosting a webinar on Wednesday, October 16, from 2 to 3:30 PM ET to provide information about the Eligible Measures Applicability (EMA) process, which checks for additional clinically related quality measures that could have been included in data submission for the Quality Performance Category of the Merit-based Incentive Payment System (MIPS).

The EMA process is applied when submitters are in a small practice and choose Medicare Part B claims as their collection type, or when submitters work with a third-...

Quality Payment Program: MIPS Dates and Deadlines

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Payment, Medicare Access and CHIP Re-authorization Act (MACRA), Merit-Based Incentive Program Payment System (MIPS), Quality Payment Program (QPP), Practice Management, Practitioners
October 10, 2019

Important Merit-based Incentive Payment System (MIPS) dates and deadlines:

  • December 31 – 2019 Promoting Interoperability Hardship Exception and Extreme and Uncontrollable Circumstances Applications deadline
  • December 31 – 2020 virtual group election period closes
  • January 2 – 2019 MIPS performance period data submission window opens
  • March 31 – 2019 MIPS performance period data submission window closes

For more information:

  • ...

Opioid Treatment Programs: Get Ready to Participate in the New Benefit

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Medication, Opioids, Practitioners
October 3, 2019

Starting January 1, 2020, under the CY 2020 Physician Fee Schedule proposed rule, the Centers for Medicare & Medicaid Services (CMS) plans to pay Opioid Treatment Programs (OTPs) through bundled payments for opioid use disorder treatment services for people with Medicare Part B, including medication-assisted treatment medications, toxicology testing, and counseling.

Get ready to participate in the...

MIPS: Virtual Group Election Period Open Through December 31

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Medicare Access and CHIP Re-authorization Act (MACRA), Merit-Based Incentive Program Payment System (MIPS), Quality Payment Program (QPP), Practitioners
October 3, 2019

To form a virtual group for the 2020 Merit-based Incentive Payment System (MIPS) performance year, you must follow an election process and submit your election to the Centers for Medicare & Medicaid Services (CMS) via email by December 31.

For more information:

  • ...

Quality Payment Program: 2019 APM Incentive Payment Fact Sheet

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Payment, Alternative Payment Models (APM), Medicare Access and CHIP Re-authorization Act (MACRA), Practice Management, Practitioners
October 3, 2019

Starting in September, clinicians who were qualifying Alternative Payment Model (APM) participants based on their 2017 performance will begin receiving 5% APM incentive payments. The Centers for Medicare & Medicaid Services (CMS) posted a new 2019 APM Incentive Payment Fact Sheet to explain:

  • Who is eligible to receive an APM incentive payment in 2019
  • How CMS determines your payment
  • Answers to frequently asked questions
    • ...

Society Asks for Parity on E&M Coding in Comments to CMS

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Payment, Merit-Based Incentive Program Payment System (MIPS), Physician Fee Schedule (PFS), Quality Payment Program (QPP), Practice Management, Practitioners
October 3, 2019

For the second year in a row, the Centers for Medicare & Medicaid Services (CMS) proposed sweeping changes to evaluation and management (E&M) coding. In its annual release of the physician fee schedule (PFS) proposed rule, CMS proposed to align the previously finalized E/M office visit coding changes with the framework adopted by the American Medical Association’s CPT Editorial Panel. Since last year’s proposal, which

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