Publications

Members only publications are marked with a lock icon:
Filter By
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...

Health Policy
September 18, 2015

The “Medicare-Required SNF PPS Assessments” Educational Tool (ICN 909067) was released and is now available in downloadable format. This educational tool is designed to provide education to Skilled Nursing Facilities (SNFs) on Prospective Payment System (PPS) assessment overviews, factors affecting the assessment schedule, and assessment results...

Health Policy
September 18, 2015

AMDA submitted comments this week on the Centers for Medicare & Medicaid Services (CMS) Proposed Rule for Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2016 and applauded CMS’ efforts to continue to address the unique needs of the post-acute and long-term care (PALTC) population.

AMDA urged CMS to finalize their proposal to provide reimbursement for advance care planning (ACP) services. “ACP is an integral...

Health Policy
September 18, 2015

This week AMDA submitted comments to the Centers for Medicare & Medicaid Services (CMS) Proposed Rule for Medicare Program; Comprehensive Care for Joint Replacement (CCJR) Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services. AMDA urged CMS to support the following principles in the development of a revised CCJR proposal and in the development of other Alternative Payment Models:

  1. Enable physician-identified improvements in care that cannot
  2. ...
Health Policy
September 18, 2015

The Centers for Medicare & Medicaid Services (CMS) has revised the training procedures for State Survey Agencies (SA) and Regional Offices (ROs) utilizing the QIS to:

  • Eliminate the mock survey and replace it with a survey of record;
  • Eliminate the T3.5 process formerly called “The Trainer Instructor Training”;
  • Update the compliance process and associated tool used for evaluating surveyors; and,
  • Clarify the role of Certified Trainers. This revised QIS training protocol does not replace the structured training program each SA and RO is required
  • ...
Health Policy
September 18, 2015

The Centers for Medicare & Medicaid Services (CMS) has posted a complete list of the 2016 ICD-10-CM valid codes and code titles on the 2016 ICD-10-CM and GEMs web page. The file is named icd10cm_codes_2016.txt. This file will be useful for physician offices and other providers who want to check to make sure that they are reporting all characters in a valid ICD-10-...

Health Policy
July 10, 2015

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) issued its annual physician fee schedule proposed rule. The rule proposes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2016.

Advance Care Planning

Among the various proposals, CMS proposes to pay for the already established Advance Care Planning CPT codes. The proposal,...