Publications

Members only publications are marked with a lock icon:
Filter By
Health Policy
May 13, 2016

A revised Transitional Care Management Services Fact Sheet is available from the Centers for Medicare & Medicaid Services (CMS). The fact sheet provides information about:

  • Who can provide the service and supervision
  • Settings, components, and billing for TCM services.
  • ...
Health Policy
May 13, 2016

Physicians and teaching hospitals have until May 15 to voluntarily review data reported by drug and medical device makers about them for CY 2015, and, if necessary, dispute payments, before the data is made public on June 30, 2016. If you have never registered in the Open Payments system, initial registration is a two-step process and should only take 30 minutes. See the Open Payments Registration webpage for more information.

If you registered...

Health Policy
May 6, 2016

On May 2, the Centers for Medicare & Medicaid Services (CMS) posted the final Quality Measure Development Plan: Supporting the Transition to the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). CMS aims to drive improvement in our national health care system through the use of quality measures and periodic assessment of the impact of such measurement. The Medicare Access and CHIP...

Health Policy
May 6, 2016

The Medicare Shared Savings Program Notice of Intent to Apply (NOIA) period is open for the January 1, 2017, program start date. The NOIA is available for:

  • Accountable Care Organizations (ACOs) not currently participating in the program (initial applicants)
  • Currently participating ACOs with a 2014 start date intending to renew their agreement (renewing applicants)
  • Currently participating ACOs in or applying to the
  • ...
Health Policy
May 6, 2016

Tuesday, May 10 from 2 to 3:30 pm ET

To Register: Visit MLN Connects Event Registration. Space may be limited, register early.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) changes the way Medicare rewards clinicians for providing quality care by streamlining multiple quality programs into a new Quality Payment Program tied to Part B Fee-For-Service payments. With the implementation of MACRA and the replacement of the Sustainable Growth Rate, we will pay clinicians participating in the...

Health Policy
May 6, 2016

Thursday, May 19 from 1:30 to 3 pm ET

To Register: Visit MLN Connects Event Registration. Space may be limited, register early.

This event gives an overview of the 2015 Mid-Year Quality and Resource Use Reports (MYQRURs) and explains how to interpret and use the information. A question and answer session will follow the presentation.

The 2015 MYQRURs were recently released to groups and solo practitioners nationwide. These reports are for informational purposes only and contain interim information...

Health Policy
April 29, 2016

This week the Centers for Medicare & Medicaid Services (CMS) issued their proposed rule for implementing certain provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). MACRA ended more than a decade of last-minute fixes to the sustainable growth rate (SGR) formula and made improvements to various health care programs by streamlining quality based payments programs such as the Physician Quality Reporting System, the Value Modifier Program, and the Medicare...

Health Policy
April 29, 2016

This week the Centers for Medicare & Medicaid Services (CMS) added six new quality measures to the Nursing Home Compare website. Three of these six new quality measures are based on Medicare-claims data submitted by hospitals, which is significant because this is the first time CMS is including quality measures that are not based solely on data that are self-reported by nursing homes. These three quality measures measure the rate of rehospitalization, emergency room use, and community discharge among...

Health Policy
April 29, 2016

On April 21, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1645-P) outlining proposed FY 2017 Medicare payment rates and quality programs for Skilled Nursing Facilities (SNFs). CMS will accept comments on the proposed rule until June 20, 2016.

Based on proposed changes, CMS projects that aggregate payments to SNFs will increase in FY 2017 by $800 million,...

Health Policy
April 29, 2016

Wednesday, May 11 from 3 to 4:30 pm ET

Join the Centers for Medicare & Medicaid Services (CMS) for an informative discussion of the comparative billing report on Subsequent Nursing Facility Evaluation and Management (E/M) Services (CBR201605), an educational tool focusing on providers who bill CPT codes 99307 through 99310 to report subsequent nursing facility E/M services. During the webinar, providers will interact directly with content specialists and submit questions about the report. See the...