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Health Policy
May 20, 2016

The Health Care Payment Learning & Action Network (HCP-LAN) final draft patient attribution white paper, entitled Accelerating and Aligning Population-Based Payment Models: Patient Attribution, includes 10 recommendations for designating the population for which a provider will accept accountability in a Population Based Payment...

Health Policy
May 20, 2016

The Centers for Medicare & Medicaid Services released the 2014 Physician Quality Reporting System (PQRS) Experience Report. This annual report provides data and trends on participation, incentive eligibility, incentive payments, and payment adjustments. Report highlights include:

  • 1.32 million professionals were eligible to participate in PQRS in 2014
  • Participation increased by 11 percent in 2014 from 2013
  • ...
Health Policy
May 13, 2016

The American Medical Association (AMA) is calling on doctors to avoid opioids, and preferably use non-pharmacologic therapy and non-opioid pharmacologic therapy. In an open letter to doctors, AMA President Steven Stack said physicians should avoid initiating opioids for new patients with chronic non-cancer pain and should limit the amount of opioids prescribed in post-operative and acute settings by prescribing the lowest effective dose for the shortest period of time if opioids are necessary.

Read Stack's letter...

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...