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New PTAC Appointments Announced

Health Policy
Centers for Medicare and Medicaid (CMS), Payment, Alternative Payment Models (APM), Practice Management, Practitioners
October 25, 2018

On October 18, 2018, the Government Accountability Office (GAO) announced the appointment of two new members to the Physician-Focused Payment Model Technical Advisory Committee (PTAC). The Medicare Access and CHIP Reauthorization Act of 2015 established PTAC to provide comments and recommendations to the Secretary of Health and Human Services on physician payment models, giving the comptroller general responsibility for appointing the committee’s 11 members.

The newly appointed members are:

  • Angelo Sinopoli, MD, chief clinical officer at Prisma Health and president
    • ...

Society Comments on CMS ACO Proposed Rule

Health Policy
Centers for Medicare and Medicaid (CMS), Payment, Accountable Care Organization (ACO), Practice Management, Practitioners
October 18, 2018

This week the Society submitted comments on the Centers for Medicare & Medicaid Services (CMS) proposed rule for Medicare Shared Savings Program; Accountable Care Organizations—Pathways to Success.

The Society commented on the following areas of the proposed rule:

  • Expanding skilled nursing facility three-day rule waiver eligibility—The Society requested that CMS remove the requirement that skilled nursing facility (SNF) affiliates must have
    • ...

CMS Offers Hand in Hand: A Training Series for Nursing Homes

Health Policy
Centers for Medicare and Medicaid (CMS), Dementia, Practitioners
October 18, 2018

Do you need in-service training on dementia management and resident abuse prevention? Hand in Hand: A Training Series for Nursing Homes from CMS focuses on caring for residents with dementia and preventing abuse. This training is updated and available in two formats:

Quality Payment Program: 2018 CME Modules, Infographics, and Scoring Guide

Health Policy
Centers for Medicare and Medicaid (CMS), Payment, Alternative Payment Models (APM), Medicare Access and CHIP Re-authorization Act (MACRA), Merit-Based Incentive Program Payment System (MIPS), Quality Payment Program (QPP), Practice Management, Practitioners
October 18, 2018

The Centers for Medicare & Medicaid Services (CMS) posted three new Continuing Medical Education (CME) modules on the Medicare Learning Network Learning Management System for the 2018 Merit-based Incentive Payment System (MIPS):

  • Improvement Activities Performance Category: Basics, including reporting requirements, scoring, and flexibilities for small and rural practices
  • Cost Performance Category: Overview and how CMS
    • ...

CMS Annual Wellness Visit Booklet Revised

Health Policy
Centers for Medicare and Medicaid (CMS), Current Procedural Terminology (CPT) codes, Practice Management, Practitioners
October 18, 2018

The revised Annual Wellness Visit booklet is available from the Centers for Medicare & Medicaid Services (CMS). Learn about:

  • Health risk assessment
  • Initial and subsequent components
  • Coding, diagnosis, and billing
    • ...

Participants in New Value-Based Bundled Payment Model Announced

Health Policy
Centers for Medicare and Medicaid (CMS), Payment, Alternative Payment Models (APM), Medicare Access and CHIP Re-authorization Act (MACRA), Practice Management, Practitioners
October 11, 2018

On October 9, the Centers for Medicare & Medicaid Services (CMS) announced that 1,299 entities have signed agreements with the agency to participate in the administration’s Bundled Payments for Care Improvement (BPCI) – Advanced Model. The participating entities will receive bundled payments for certain episodes of care as an alternative to fee-for-service payments that reward only the volume of care delivered. Model participants include 832 Acute Care Hospitals and 715 Physician Group Practices – a total of 1,547 Medicare providers and suppliers, located in 49 states plus Washington,...

Submit a MIPS Targeted Review Request by October 15

Health Policy
Centers for Medicare and Medicaid (CMS), Payment, Medicare Access and CHIP Re-authorization Act (MACRA), Merit-Based Incentive Program Payment System (MIPS), Practice Management, Practitioners
October 11, 2018

If you participated in the Merit-based Incentive Payment System (MIPS) in 2017, your MIPS score and performance feedback are available on the Quality Payment Program website. The payment...

Congressional Opioid Legislation Agreement Expected to be Signed by President

Health Policy
Opioids, Pain Management, Practitioners
October 4, 2018

After months of hearings and debate, the House and the Senate reached agreement this week on legislation to address the opioid epidemic.  The House passed the legislation by a vote of 393 to 8 and the Senate by a vote of 99 to 1. The Senate then agreed to the House amendments and final passage by a vote of 98 to 1. President Trump is expected to sign the bill into law. 

The legislation, the “SUPPORT for Patients and Communities Act” (H.R. 6), touches on almost every aspect of the unrelenting epidemic that is affecting communities across the nation, including numerous...

Recording Now Available: The Society’s Webinar on MACRA, MIPS AND APMS: Current Requirements and Proposed Changes

Health Policy
Centers for Medicare and Medicaid (CMS), Payment, Alternative Payment Models (APM), Medicare Access and CHIP Re-authorization Act (MACRA), Merit-Based Incentive Program Payment System (MIPS), Quality Payment Program (QPP), Practice Management, Practitioners
October 4, 2018

The Society was happy to host a free webinar for members featuring senior Centers for Medicare & Medicaid Services (CMS) officials. The webinar detailed the requirements of the 2018 Quality Payment Program (QPP) as well as the proposed changes for the 2019 program and reporting requirements for the Merit-based Incentive Payment System (MIPS) and Alternative Payment Model (APM) option.

The proposed rule suggested a number of changes to the QPP, including the minimum reporting required to avoid penalties and MIPS eligibility status for group practices. In addition, the proposed...

CMS Patient Relationship Categories and Codes Webcast Scheduled for October 17

Health Policy
Centers for Medicare and Medicaid (CMS), Payment, Coding, Reimbursement, & Documentation, Quality Payment Program (QPP), Practice Management, Practitioners
October 4, 2018

On Wednesday, October 17, from 1:30 to 3 pm ET, CMS will host a webinar on patient relationship categories and codes. The webinar will focus on guidance for classifying patient relationships during the voluntary reporting period that CMS implemented on January 1, 2018. It presents real world clinical scenarios to illustrate how patient Relationship categories and codes work and reviews the statutory context and policy principles used in their development. A question and answer session will follow the presentation.

For inquiries about the patient relationship categories and codes,...