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Health Policy
October 16, 2015

This week AMDA submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the Proposed Rule Reform of Requirements for Long-Term Care Facilities. AMDA’s extensive comments showed an overall support of the intention of the updates, provided recommendations, and shared concerns regarding some of the proposals.

AMDA concurs with CMS that quality care should be focused on the resident of the nursing home and that while quality has improved over the past two decades, there are additional improvements needed. “We support the proposal to combine quality of...

Health Policy
October 16, 2015

On October 7, CMS announced promising results of the first shared savings performance year for the Comprehensive Primary Care (CPC) initiative. In 2014, CPC practices showed positive quality results, with hospital readmissions lower than national benchmarks and high performance on patient experience measures, particularly on provider communication with patients and timely access to care. CPC practices that demonstrated high quality care and reduced spending above a threshold shared in savings generated for Medicare.

During this first shared savings performance year, the initiative...

Health Policy
October 16, 2015

Affordable Care Act model designed to improve care for beneficiaries with kidney failure while reducing costs

CMS announced the participants for the Comprehensive End-Stage Renal Disease (ESRD) Care (CEC) Model, a new Accountable Care Organization (ACO) model. The CEC Model is designed specifically for beneficiaries with ESRD and builds on experiences from other models and programs with ACOs, including the Pioneer ACO Model and the Medicare Shared Savings Program.

In the CEC Model, dialysis facilities, nephrologists, and other providers have joined together to form...

Health Policy
October 16, 2015

To access a product available for order in a hard copy format, go to Medicare Learning Network Products, scroll down to the bottom of the web page to the “Related Links” section, and click on the “Medicare Learning Network Product Ordering Page.”

Health Policy
October 9, 2015

The Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) released final rules that simplify requirements and add new flexibilities for providers to make electronic health information available when and where it matters most and for health care providers and consumers to be able to readily, safely, and securely exchange that information. The final rule for 2015 Edition Health IT Certification Criteria (2015 Edition) and final rule with comment period for the Medicare and Medicaid Electronic Health Records (EHRs)...

Health Policy
October 9, 2015

The Centers for Medicare and Medicaid Services (CMS) has opened the 30-day preview period for the 2014 quality measures that will be reported on Physician Compare later this year. You can...

Health Policy
October 2, 2015

The Federal Health IT Strategic Plan 2015 – 2020, was released last week and outlines the commitments of all the agencies that use or influence the use of health IT across the nation for the next five years. The Plan is an action plan for federal partners, as they work to expedite high-quality, accurate, secure, and relevant electronic health information for stakeholders across the nation. The Plan’s strategies for achieving this aim focus on making electronic...

Health Policy
September 18, 2015

AMDA – The Society for Post-Acute and Long-Term Care Medicine, along with the American Medical Association and 40 other organizations, recently sent a letter to Secretary of Health and Human Services Sylvia Burwell asking for a pause in the meaningful use stage 3 program as well as a reevaluation the full program in light of new changes to Medicare with the passage of the Medicare Access and Chip Reauthorization Act (MACRA) and the development of the MIPS payment system.

“The proposed MU Stage 3 regulation...

Health Policy
September 18, 2015

On July 6, 2015, CMS and the American Medical Association (AMA) released a joint statement about their efforts to help the provider community get ready for ICD-10. This statement included guidance from CMS that allows for flexibility in the claims auditing and quality reporting processes. In response to questions from the health care community, CMS released...

Health Policy
September 18, 2015

On September 11, CMS began distributing letters to Physician Quality Reporting System (PQRS) individual Eligible Professionals (EPs), EPs providing services at Critical Access Hospitals billing under method II, and group practices about the 2016 PQRS negative payment adjustment. The letter indicates that an individual or group did not satisfactorily report 2014 PQRS quality measures in order to avoid the 2.0% 2016 negative PQRS payment adjustment.

If I received the payment adjustment letter, what are my options?

If you believe that you have been incorrectly...