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eCQM Value Sets: Updates for 2019 Reporting and Performance Periods

Health Policy
Centers for Medicare and Medicaid (CMS), Payment, Coding, Reimbursement, & Documentation, Medicare Access and CHIP Re-authorization Act (MACRA), Quality Payment Program (QPP), Health Information Technology (HIT), Practitioners
September 20, 2018

The Centers for Medicare & Medicaid Services (CMS) and the National Library of Medicine (NLM) published updates to the electronic Clinical Quality Measure (eCQM) value sets to align with recent releases to terminologies, including, ICD-10-CM/PCS, SNOMED CT, LOINC, and RxNorm. This addendum affects the electronic reporting of eCQMs for the following programs:

  • Quality Payment Program: Merit-based Incentive Payment System and Advanced Alternative Payment Models
  • Comprehensive Primary Care Plus
  • Hospital Inpatient Quality Reporting
  • Medicare and
    • ...

MIPS Targeted Review Request: Deadline Extended to October 15

Health Policy
Centers for Medicare and Medicaid (CMS), Payment, Medicare Access and CHIP Re-authorization Act (MACRA), Merit-Based Incentive Program Payment System (MIPS), Practitioners
September 20, 2018

If you participated in the Merit-based Incentive Payment System (MIPS) in 2017, your MIPS final score and performance feedback are available on the Quality Payment Program website. The payment adjustment you receive in 2019 is based on this final score. If you believe there is an error in your 2019 MIPS payment adjustment calculation, you can request a targeted review until October 15 at 8 pm ET.

Here are some good resources to get more information:

    • ...

Society Comments on 2019 Physician Fee Schedule and QPP Proposed Rule

Health Policy
Centers for Medicare and Medicaid (CMS), Payment, Alternative Payment Models (APM), Medicare Access and CHIP Re-authorization Act (MACRA), Merit-Based Incentive Program Payment System (MIPS), Physician Fee Schedule (PFS), Quality Payment Program (QPP), Health Information Technology (HIT), Practitioners
September 13, 2018

This week the Society submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the CY 2019 Physician Fee Schedule (PFS) and Quality Payment Program (QPP) proposed rule. The Society noted that they were appreciative of CMS’ focus to reduce burden in both evaluation and management (E&M) documentation requirements and reporting into the Quality Payment Program (QPP): “We agree that clinicians need administrative burden relief so that they focus more on patient care. While we support these general efforts, we feel CMS must work in a collaborative and open manner with...

Join AMDA Member and CMS on Call about Dementia Care: Opioid Use & Impact for Persons Living with Dementia

Health Policy
Centers for Medicare and Medicaid (CMS), Dementia, Opioids, Practitioners
September 13, 2018

The CMS National Partnership to Improve Dementia Care and Quality Assurance Performance Improvement is hosting a call on Tuesday, September 18, from 1:30 to 3 pm ET.

During this call, you can gain insight on opioid use in the post-acute and long-term care setting, as well as learning about the impact of opioid use on persons living with dementia. CMS also will share updates on the progress of the National...

House Hearing Focuses on Nursing Home Safety and Quality

Health Policy
Care Settings/Types, Skilled Nursing Care, Centers for Medicare and Medicaid (CMS), Federal Regulations, Practitioners, Quality
September 6, 2018

This week, the House Committee on Energy and Commerce (E&C) Subcommittee on Oversight and Investigations held a hearing entitled “Examining Efforts to Ensure Quality of Care and Resident Safety in Nursing Homes.” The purpose of the hearing was to explore the roles of the Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General at the U.S. Department of Health and Human Services (HHS) relating to the management and safety of nursing facilities.

Witnesses for the hearing included Kate Goodrich, MD, Director at the Center for Clinical Standards and...

CMS Dementia Care: Opioid Use & Impact for Persons Living with Dementia Call — September 18

Health Policy
Centers for Medicare and Medicaid (CMS), Dementia, Practitioners
September 6, 2018

National Partnership to Improve Dementia Care and Quality Assurance Performance Improvement

Tuesday, September 18 from 1:30 to 3 pm ET

Register  for Medicare Learning Network events.

During this call, gain insight on opioid use in the post-acute and long-term care setting. Also, learn...

Society Joins Opposition to CMS’ Proposed Cuts to E/M Pay

Health Policy
Centers for Medicare and Medicaid (CMS), Payment, Coding, Reimbursement, & Documentation, Practitioners
August 30, 2018
This week, the Society joined the American Medical Association and over 150 other medical organizations in opposing the Centers for Medicare & Medicaid Services (CMS) proposal to simplify evaluation and management (E/M) coding. The CMS proposal would collapse payment rates for eight office visit services for new and established patients down to two each. The proposed simplification would increase payments for services now provided under E/M levels 2 and 3 but would decrease payments for the more complex services now...

ACOs Taking Risk in Innovative Payment Model Generate Savings for Patients and Taxpayers

Health Policy
Centers for Medicare and Medicaid (CMS), Payment, Accountable Care Organization (ACO), Practitioners
August 30, 2018

On August 27, CMS released an evaluation report for the first performance year of the Innovation Center’s Next Generation Accountable Care Organization (ACO) Model showing promising early results. Results demonstrated the positive outcomes in terms of quality and costs when providers are responsible for managing to a budget. For the 2016 performance year, the Next Generation ACO Model generated net savings to Medicare of approximately $62 million while maintaining quality of care for beneficiaries. As part of its recent “Pathways to Success” proposal, CMS proposed taking many...

MIPS Targeted Review Request: Deadline October 1

Health Policy
Centers for Medicare and Medicaid (CMS), Payment, Merit-Based Incentive Program Payment System (MIPS), Quality Payment Program (QPP), Practitioners
August 30, 2018

If you participated in the Merit-based Incentive Payment System (MIPS) in 2017, your MIPS final score and performance feedback are available on the Quality Payment Program website. The payment adjustment you receive in 2019 is based on this final score. If you believe there is an error in your 2019 MIPS payment adjustment calculation, you can request a targeted review until October 1 at 8 pm.

Contact the Quality Payment Program at 866-288-8292 (TTY: 877-715-6222) or ...

CMS Posts New Proposed RAC Review Topics

Health Policy
Skilled Nursing Care, Centers for Medicare and Medicaid (CMS), Practitioners
August 30, 2018

The Centers for Medicare & Medicaid Services (CMS) has posted 10 new proposed Recovery Audit Contractor (RAC) Review Topics to its website for a 30-day comment period. CMS began posting the proposed review topics last year in response to specialty societies that wanted to have the opportunity to provide feedback before the review topics are finalized. There are a few proposed review topics of particular interest...