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Policy Snapshot
October 21, 2016

On October 13, the Centers for Medicare & Medicaid Services (CMS) announced a new initiative to improve the clinician experience with the Medicare program. As delivery system reforms from the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) are implemented, this new long-term effort aims to reshape the physician experience by reviewing regulations and policies to minimize administrative tasks and seek other input to improve clinician satisfaction. The initiative will be led by senior physicians within CMS who will report to the Office of the...

Policy Snapshot
October 21, 2016

On October 17, the Centers for Medicare & Medicaid Services (CMS) announced the Comprehensive Primary Care (CPC) initiative’s second round of shared savings results, with nearly all practices (95 percent) meeting quality of care requirements and four out of seven regions sharing in savings with CMS. These results reflect the work of 481 practices that served over 376,000 Medicare beneficiaries and more than 2.7 million patients overall in 2015.

During 2015, its second...

Policy Snapshot
October 21, 2016

Thursday, October 27 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 final rule to reform the requirements for long-term care facilities. These requirements are the federal health...

Policy Snapshot
October 14, 2016

Thursday, October 27 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 final rule to reform the requirements for long-term care facilities. These requirements are the federal health...

Policy Snapshot
October 14, 2016

Last week, the Government Accountability Office (GAO) publicly released their report on skilled nursing facilities (SNF) where they were asked to provide information on how SNFs spend their Medicare and other revenues. GAO examined the extent to which the expenditure data the Centers for Medicare & Medicaid Services (CMS) collects from SNFs and provides to the public are accessible and reliable, how SNF costs and margins vary by facility characteristics, and how SNF nurse staffing levels vary by facility characteristics and the relationship between SNF nurse staffing levels and margins...

Policy Snapshot
October 14, 2016

On October 6, the Centers for Medicare & Medicaid Services (CMS) released a privacy-protected public data set, the Hospice Utilization and Payment Public Use File (Hospice PUF), which provides information on services provided to Medicare beneficiaries by hospice providers. CMS also released an update to the Market Saturation and Utilization Data Tool.

  • The Hospice PUF contains information on utilization, payments, submitted charges, diagnoses, and hospice beneficiary demographics organized by provider and state. The Hospice PUF covers CY 2014 and includes information on 4
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Policy Snapshot
October 7, 2016

This week, AMDA – The Society for Post-Acute and Long-Term Care Medicine submitted comments to the Centers for Medicare & Medicaid Services (CMS) on their Proposed Rule for Medicare entitled Advancing Care Coordination Through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model (CJR). A brief summary of those comments are below:

Data Sharing: The Society agrees with CMS’ concerns about data sharing of key information for EPM collaborators. Practice groups in post-acute and long...

Policy Snapshot
October 7, 2016

The Centers for Medicare & Medicaid Services (CMS) awarded $347 million to 16 national, regional, or state hospital associations, Quality Improvement Organizations, and health system organizations to continue efforts in reducing hospital-acquired conditions and readmissions in the Medicare program. The Hospital Improvement and Innovation Network contracts build upon the collective momentum of the Hospital Engagement Networks and Quality Improvement Organizations to reduce patient harm and readmissions.

Through 2019, these Hospital Improvement and Innovation Networks will work...

Policy Snapshot
October 7, 2016

The Medicare Operations Division Electronic Filing System (MOD E-File), launched on October 1, 2016, allowing appellants to file electronic requests for review with the Medicare Appeals Council. Appellants, parties, and the public can also use MOD E-File to check the status of appeals. Visit the MOD E-File website to learn more about MOD E-File and how to use it.

Policy Snapshot
October 7, 2016

The American Medical Association issued a new Current Procedural Terminology (CPT) code for influenza vaccine Flucelvax, CPT 90674, effective August 1, 2016 for Medicare claims. However, Medicare claims processing systems will not be able to accept the new code until January 1, 2017. Until this time, you may hold claims containing CPT 90674. Alternatively, Medicare Administrative Contractors (MACs) may direct use of a Not Other Classified (NOC) code to allow billing for the vaccine for dates of service on or after August 1, 2016, and before January 1, 2017. Check with your MAC for this...