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Health Policy
December 18, 2015

It is likely that 2015 will be remembered as a crucial year of policy implementation that will set the stage for the future of health care delivery. It began early last January with an announcement from Health and Human Services (HHS) Secretary Sylvia Burwell that left the fee-for-service as the sole reimbursement model in the dust and moved us with lighting speed into the future of health care delivery. HHS has set a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations...

Health Policy
December 11, 2015

To help eligible professionals, eligible hospitals, and Critical Access Hospitals (CAHs) successfully participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs in 2015, the Centers for Medicare & Medicaid Services (CMS) posted new resources on the EHR Incentive Programs website.

  • What You Need to Know for 2015:
  • ...
Health Policy
December 11, 2015

Electronic submission of staffing data through the Payroll-Based Journal (PBJ) is required for long-term care facilities beginning July 1, 2016. To prepare, nursing homes should register to submit data to meet this requirement and maintain compliance.

  • Obtain a CMSNet User ID for PBJ if you do not already have one for other Quality Improvement and Evaluation System (QIES) applications
  • Obtain a PBJ QIES Provider ID for
  • ...
Health Policy
December 4, 2015

On November 25, CMS shared the updated 2016 CMS Quality Strategy, which incorporates progress made in shifting Medicare payments from volume to value, including payment reform initiatives, as well as new requirements from the Improving Medicare Post-Acute Care Transformation Act of 2014 and the Medicare Access and CHIP Reauthorization Act of 2015 legislation. The 2016 CMS Quality Strategy helps to align all of CMS to:...

Health Policy
December 4, 2015

In response to feedback from stakeholders and partners of the National Partnership to Improve Dementia Care in Nursing Homes, CMS is sharing the revised survey materials that were developed for the 2014 Focused Dementia Care Survey Pilot and 2015 expansion effort. The intent is that facilities would use these tools to assess their own practices in providing resident care.

The tools can be accessed by clicking here....

Health Policy
December 4, 2015

On October 30, the Centers for Medicare & Medicaid Services (CMS) issued the final rule that updates the payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (MPFS) on or after January 1, 2016. The rule changes several of the quality reporting initiatives associated with MPFS payments, including the Physician Quality Reporting System (PQRS).

...

Health Policy
November 20, 2015

This week AMDA, submitted comments to the Centers for Medicare & Medicaid Services (CMS) on their Request for Information (RFI) regarding the implementation of Alternative Payment Models (APMs) and Merit-Based Incentive Programs (MIPS) under the Medicare Access and CHIP Reauthorization Act (MACRA).

AMDA noted that “if properly implemented, the new physician payment framework will promote improvements in the delivery of care to Medicare patients.” To help clinicians make the transition to new care and delivery models and ensure access to high-quality care for all patients, AMDA...

Health Policy
November 20, 2015

his week the American Medical Association (AMA) House of Delegates (HoD) met to deliberate a number of policies at the 2015 Interim Meeting held in Atlanta, Georgia. During the meeting, attended by AMDA Delegate Eric Tangalos, MD, CMD, Alternate Delegate Rajeev Kumar, MD, CMD, and Director of Public Policy and Advocacy Alex Bardakh, MPP, the AMA HoD adopted a number of policies ranging from public health issues to physician value-based purchasing programs. Highlighting the list of policy directives to the AMA were resolutions asking the AMA to “seek exemptions from Meaningful Use penalties...

Health Policy
November 20, 2015

The Office of Inspector General for Health and Human Services (OIG) recently issued its 2016 Work Plan, which sets the agenda for its auditing and investigation in the year ahead. The broad mandate of the OIG is to eliminate fraud, waste and abuse. The work plan describes more than 100 initiatives, 43 of which are new, for the upcoming year. The plan focuses on a variety of different health care aspects including nursing homes, home health agencies, pharmacies and hospitals.

In the past, the OIG has had success with recovering Medicare payments for therapy in nursing homes. Now the...