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Health Policy
February 25, 2016

Many Medicare residents entering into a skilled nursing facility (SNF) are coming from the acute hospital setting. In order to receive the paid Medicare SNF benefit they must have received inpatient status for three consecutive days during their hospital stay. Those not classified as inpatient but rather as observation are consequently charged for SNF services. The Improving Access to Medicare Coverage Act of 2015 would count all time (inpatient or observation) spent in the hospital towards the required three day stay.

AMDA has long supported this legislation and has had...

Health Policy
February 24, 2016

This week the Centers for Medicare & Medicaid Services (CMS) and America’s Health Insurance Plans (AHIP), as part of a broad Core Quality Measures Collaborative of health care system participants, released seven sets of clinical quality measures. These measures support multi-payer alignment, for the first time, on core measures primarily for physician quality programs. This work is informing CMS’s implementation of the Medicare Access and CHIP Reauthorization...

Health Policy
February 19, 2016

AMDA is proud to announce that it has joined the The Family Caregiver Platform Project. The project is a nonpartisan effort to include caregiving issues in the state party political platforms across the country. The group works to educate and motivate policymakers to improve state and federal support for family caregivers and the frail elderly Americans for whom they selflessly provide support.

National partners in the effort include LeadingAge, Caring Across Generations, National Alliance for Caregiving, and Altarum Institute.

To learn more or to get involved visit...

Health Policy
February 19, 2016

At AMDA’s upcoming Annual Conference in Orlando, Florida, a number of AMDA policy leaders will spotlight how health care reform changes will impact the post-acute and long-term care (PALTC) sector. At an all-day intensive session on Thursday, March 17 entitled Changing Health Care Delivery Environment: In Depth Analysis of Post-Acute/Long-Term Care in the New Age of Health Care, AMDA policy leaders will cover topics around value-based purchasing including the status of Accountable Care Organizations (ACOs), bundled payment initiatives, development of quality measures, and the role...

Health Policy
February 19, 2016

On February 3, the Centers for Medicare & Medicaid Services (CMS) released the annual report summarizing impacts from the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents in 2014. The project is designed to test ways to reduce avoidable hospitalizations among long-stay nursing facility residents.

During 2014, all seven sites generally showed reductions in Medicare...

Health Policy
February 5, 2016

The Senate Finance Committee Chronic Care Working Group recently released their options paper outlining policies being considered as a part of the committee’s effort to improve how Medicare treats beneficiaries with multiple, complex chronic illnesses.

AMDA’s comments to the committee included supporting “proposals that provide additional chronic care management services” to the post-acute and long-term care (PALTC) population. AMDA supported the establishment of additional high-severity...

Health Policy
February 5, 2016

The Centers for Medicare & Medicaid Services (CMS) launched important changes to the Medicare Electronic Health Record (EHR) Incentive Program hardship exception process that will reduce burdens on clinicians, hospitals, and Critical Access Hospitals (CAHs).

  • New FAQ: On the new hardship application form for the 2017 payment adjustment, there is nothing which says documentation is required to be submitted with the application form. Does this mean that CMS will only require the selection of a hardship category and the completion of the provider’s identifying information in
  • ...
Health Policy
February 5, 2016

Plan Strengthens Incentives for ACOs to Improve Performance

On January 28, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to update the methodology used to measure the performance of Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program. Key proposals include:

  • Recognizing that health cost trends vary in communities across the country by using regional, rather than national, spending growth trends when establishing and updating an ACO’s rebased benchmark.
  • Adjusting an ACO’s rebased benchmark when it
  • ...
Health Policy
February 5, 2016

Physicians and teaching hospitals, you must register in the Open Payments system to review any payments or transfers of value attributed to you. The review and dispute period is targeted to start in April 2016, following the close of data submission.

If you registered last year, you are not required to recertify your registration. However, if it has been over 180 days since you logged onto the Enterprise Identity Management System, the account has been deactivated for security purposes.

Visit the...

Health Policy
January 29, 2016

Eligible Professionals who do not satisfactorily report quality measure data to meet the 2015 Physician Quality Reporting System (PQRS) requirements will be subject to a negative PQRS payment adjustment on all Medicare Part B physician fee schedule services for 2017. Submissions end at 8 pm ET:

  • Electronic Health Record direct or data submission vendor (QRDA I or III) – January 1 through February 29, 2016
  • Qualified clinical data registries (QCDRs) (QRDA III) – January 1 through February 29, 2016
  • Group practice reporting option web interface – January 18
  • ...