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Policy Snapshot
April 8, 2016

The Centers for Medicare & Medicaid Services (CMS) released the 2015 Mid-Year Quality and Resource Use Reports (MYQRURs) to groups and solo practitioners nationwide. MYQRURs are for informational purposes only and will not affect your payments under the Medicare Physician Fee Schedule. For more information, visit the 2015 QRUR and 2017 Value Modifier webpage. See the...

Policy Snapshot
April 8, 2016

Thursday, April 14 from 2 to 3 pm ET

To Register: Visit MLN Connects Event Registration. Space may be limited, register early.

During this call, Centers for Medicare & Medicaid Services (CMS) subject matter experts discuss the development of the Data Element Library.

A question and answer session will follow the presentation, including an opportunity for registrants to provide feedback on the Library. The...

Policy Snapshot
April 8, 2016

A revised Accountable Care Organizations: What Providers Need to Know Fact Sheet is available. Learn about: 

  • Participating in the Medicare Shared Savings Program
  • Coordinating care through Accountable Care Organizations (ACOs)
  • Satisfying the quality performance standards

And a revised...

Policy Snapshot
April 8, 2016

Shortages Particularly Acute in Specialties Most Needed by an Aging Population

Under every combination of scenarios modeled, the United States will face a shortage of physicians over the next decade, according to a physician workforce report released this week by the AAMC (Association of American Medical Colleges). The projections show a shortage ranging between 61,700 and 94,700, with a significant shortage showing among many surgical specialties....

Policy Snapshot
April 1, 2016

The Centers for Medicare & Medicaid Services (CMS) today announced it will test whether a new payment model for nursing facilities and practitioners will further reduce avoidable hospitalizations, lower combined Medicare and Medicaid spending, and improve the quality of care received by nursing facility residents.

This next phase of the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents seeks to reduce avoidable hospitalizations among beneficiaries eligible for Medicare and/or Medicaid by providing new payments to practitioners for...

Policy Snapshot
April 1, 2016

Over the last year, AMDA - The Society for Post-Acute and Long-Term Care Medicine has asked the Centers for Medicare & Medicaid Services (CMS) to clarify whether the Chronic Care Management (CCM) Current Procedural Terminology (CPT) code was billable in nursing facilities. The original descriptor per AMA CPT for CCM stated that “these [CCM] management and support services are provided to patients who reside at home or in a domiciliary, rest home, or assisted living facility” which left confusion about billing the code in skilled nursing facility and nursing facility (SNF/NF) settings....

Policy Snapshot
April 1, 2016

Tuesday, April 5 from 1:30 to 3 pm ET

To Register: Visit MLN Connects Event Registration. Space may be limited, register early.

During this call, CMS subject matter experts provide information on what you can do to prepare for the Medicare Shared Savings Program (Shared Savings Program) application process for the January 1, 2017, program start date. A question and answer session will follow the presentation.

We encourage call participants to review important information, dates, and...

Policy Snapshot
March 25, 2016

Last week, the Centers for Medicare & Medicaid Services (CMS) released survey and certification letter (S&C 16-13-NH) which reminds long-term care facilities that the mandatory submission period for electronic reporting on staffing begins on July 1, 2016. The Society for Post-Acute and Long-Term Care Medicine met with CMS and argued that the “on site” requirement for reporting Medicare Director hours could lead to...

Policy Snapshot
March 25, 2016

The Centers for Medicare & Medicaid Services (CMS) recently released a frequently asked questions document about bill advance care planning (ACP) services under Current Procedural Terminology (CPT) codes 99497 and 99498 billable under Medicare starting January 1, 2016. CPT Code 99497 includes “advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or...

Policy Snapshot
March 25, 2016

The Centers for Medicare & Medicaid Services (CMS) will issue a national provider Comparative Billing Report (CBR) on Subsequent Nursing Facility Evaluation and Management (E/M) Services in April 2016. The CBR, produced by CMS contractor eGlobalTech, will focus on providers of all specialties who bill Current Procedural Terminology codes 99307 through 99310 to report subsequent nursing facility E/M services. CBRs contain data-driven tables with an explanation of findings that compare providers’ billing and payment patterns to those of their peers in their state and across the nation....