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Policy Snapshot
December 2, 2016

This week, President-Elect Trump announced that Congressman Tom Price, MD, (R-GA) will become the next Health and Human Services (HHS) Secretary. Dr. Price is an orthopedic surgeon and has served in the House of Representatives for 14 years, currently as the Chair of the House Budget Committee.

The American Medical Association (AMA) has come out in support of Dr. Price’s nomination stating that “his service as a physician, state legislator and member of the U.S. Congress provides a depth of experience to lead HHS. Dr. Price has been a leader in the development of health policies to...

Policy Snapshot
December 2, 2016

Each year, the Centers for Medicare & Medicaid Services (CMS) publishes a list of quality and cost measures that are under consideration for Medicare quality and value-based purchasing programs and collaborates with the National Quality Forum (NQF) to get critical input from multiple stakeholders, including patients, clinicians, commercial payers and purchasers, on the measures that are best suited for these programs. This year’s Measures under Consideration (MUC) List contains 97 measures that have the potential to drive improvement in quality across numerous settings of care....

Policy Snapshot
December 2, 2016

Tuesday, December 6 from 1:30 to 3 pm ET

To register or for more information, visit MLN Connects® Event Registration.

During this call, learn about the reform of requirements for long-term care facilities, highlighting the Behavioral Health Services & Pharmacy Services sections. A Tennessee nursing home will also discuss innovative approaches that they implemented to dramatically reduce the use of antipsychotic medications. Additionally, Centers for Medicare &...

Policy Snapshot
December 2, 2016

The informal review period for the 2017 Value Modifier calculation has been extended to December 7. For information on how to file, see the 2017 Value Modifier Informal Review Request Quick Reference Guide.

For More Information:

Policy Snapshot
December 2, 2016

It is hard to believe that we spent almost two decades trying to repeal the flawed Sustainable Growth Rate (SGR) formula that defined how physicians got paid and now, in a blink of an eye, we must get used to a whole new way of doing business. The game changing legislation known as MACRA (Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015) builds on already existing programs and creates new ways physicians and other providers will now be getting paid. The legislation created two pathways for physician payment now known as the Merit-Based Incentive Payment...

Policy Snapshot
November 18, 2016

The American Medical Association (AMA) interim meeting is devoted to advocacy. It remains a much-abbreviated meeting from the annual event held every June in Chicago. The Society had no resolutions to present at the recent interim meeting, held in Orlando, FL, but a number of issues were of interest.

The Reference Committee on Medical Service had the most packed agenda and drew the most attention. It also had a number of resolutions for which the Society has existing policy. One that garnered additional discussion before the full House was on health care while incarcerated. State...

Policy Snapshot
November 18, 2016

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) Work Plan for fiscal year (FY) 2017 summarizes new and ongoing reviews and activities that OIG plans to pursue with respect to HHS programs and operations during the current fiscal year and beyond. Work planning is an ongoing and evolving process, and the Work Plan is updated throughout the year. This edition of the Work Plan describes OIG audits and evaluations that are underway or planned, and certain legal and investigative initiatives that are continuing. It also notes items that have been...

Policy Snapshot
November 18, 2016

Thursday, December 6 from 1:30 to 3 pm ET

To register or for more information, visit MLN Connects Event Registration. Space may be limited, register early.

During this call, learn about the reform of requirements for long-term care facilities, highlighting the Behavioral Health Services & Pharmacy Services sections. A Tennessee nursing home will also discuss innovative approaches that they implemented to dramatically reduce the use of antipsychotic medications....

Policy Snapshot
November 11, 2016

In 2017, the Centers for Medicare & Medicaid Services (CMS) will apply a downward payment adjustment to those who did not satisfactorily report for the Physician Quality Reporting System (PQRS) in 2015 including:

  • Individual eligible professionals
  • Comprehensive Primary Care practice sites
  • PQRS group practices
  • Accountable Care Organizations

If you believe you have been incorrectly assessed the 2017 PQRS payment adjustment, submit an informal review through November 30:

  • See
  • ...
Policy Snapshot
November 11, 2016

The 2015 Annual Quality and Resource Use Reports (QRURs) were released on September 26. These reports show how physician groups and physician solo practitioners performed in 2015 on the quality and cost measures used to calculate the 2017 Value Modifier. Access and review your 2015 Annual QRUR now to determine whether you are subject to the 2017 Value Modifier payment adjustment. See the How to Obtain a QRUR webpage and...