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Policy Snapshot
May 30, 2019

On May 28, the Centers for Medicare & Medicaid Services (CMS) finalized a rule to update and modernize the Programs of All-Inclusive Care for the Elderly (PACE). PACE provides comprehensive medical and social services to certain frail, elderly individuals who qualify for nursing home care but, at the time of enrollment, can still live safely in the community. The majority of participants are dually eligible for both Medicare and Medicaid.

The final rule revises and updates the requirements for the PACE program under Medicare and Medicaid, including:

  • Strengthening
  • ...
Policy Snapshot
May 30, 2019

Recently the Centers for Medicare & Medicaid Services (CMS) released its final rule on Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses. These changes will ensure that patients have greater transparency into the cost of prescription drugs in Part D and will also enable Medicare Advantage plans to negotiate better prices for physician-administered medicines in Part C.

Part D Protected Classes

Current Part D policy requires sponsors to include on their formularies all drugs in six categories or classes...

Policy Snapshot
May 30, 2019

The Centers for Disease Control and Prevention (CDC) is raising awareness of the risk to patient health and safety due to misapplication of the opioid guideline for chronic pain.  Please read the recent commentary in the New England Journal of Medicine, where authors of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain advise against misapplication of the guideline that can put patients’ health and safety at ...

Policy Snapshot
May 23, 2019

Last week, Reps. Jan Schakowsky (D-IL) and Michael C. Burgess (R-TX) introduced the bipartisan EMPOWER for Health Act of 2019 (H.R. 2781) in the U.S. House of Representatives.  The bill reauthorizes many workforce programs under Title VII of the Public Health Service Act, including geriatrics, and would ensure communities across the United States have access to health professionals and other critical supports to improve care for an aging population....

Policy Snapshot
May 23, 2019

Skilled Nursing Facility (SNF) Provider Preview Reports are available from the Centers for Medicare & Medicaid Services (CMS). Review your performance data by May 30, prior to public display on Nursing Home Compare in July 2019. Corrections to the underlying data are not permitted during this time; request a CMS review if you believe your data is inaccurate.

For more information:

  • ...
Policy Snapshot
May 23, 2019

Beginning this year, all Promoting Interoperability Program participants must use 2015 Edition Certified Electronic Health Record (EHR) Technology (CEHRT) to avoid a downward Medicare payment adjustment. 2019 CEHRT requirements:

  • Did not need to be in place by January 1, 2019, but must be used for the entire EHR reporting period of any continuous, self-selected 90-day period
  • Functionality must be in place by the first day of the EHR reporting period and the product must be certified to the 2015 Edition criteria by the last day of the EHR reporting period
  • ...
Policy Snapshot
May 16, 2019

Once again this year, the Society is a strategic collaborator for the Health IT Collaborative Care Summit taking place in Baltimore, June 23-25, 2019. The Summit, annually organized by the Long-Term and Post-Acute Care Health Information Technology (LTPAC HIT) Collaborative, will continue to focus on bringing LTPAC providers together with acute care providers, payers, health IT vendors, health information exchange intermediaries, consultants, system integrators, and solution providers to engage in discussing how...

Policy Snapshot
May 16, 2019

This week a bipartisan group of senators introduced a piece of legislation to help end surprise medical billing. The STOP Surprise Medical Bills Act calls for an arbitration process for settling disputes between providers and insurers. Under the bill, arbitration would be an option providers and insurers could use if they are unhappy with the payment they receive as a result of out-of-network services. The Senate bill would ensure that a patient only pays in-network cost-sharing rates for emergency services and would protect patients who are taken to out-of-network facilities in...

Policy Snapshot
May 16, 2019

The Centers for Medicare & Medicaid Services (CMS) posted the Electronic Clinical Quality Measure (eCQM) specifications for the 2020 reporting period for eligible hospitals and critical access hospitals and 2020 performance period for ...

Policy Snapshot
May 16, 2019

During the webinar—which is being held on Thursday, May 23, from 1 to 2 PM ET, CMS experts will provide a brief overview of the Merit-based Incentive Payment System (MIPS) and discuss the following Improvement Activities Performance Category topics:

  • Basics
  • Reporting requirements
  • Data submission
  • Scoring
  • Flexibilities for small and rural practices
  • Resources

Register today....