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Policy Snapshot
May 9, 2019

This week, the Senate Finance Committee held a hearing on Medicare Physician Payment Reform After Two Years: Examining MACRA Implementation and the Road Ahead. The hearing examined how well the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 met and continues to meet its goals for improving quality of care for Medicare beneficiaries.

Witnesses included leaders in the physician community, including Barbara McAneny, MD, president of the American Medical Association; John Cullen, MD, FAAFP, president of the American Academy of Family Physicians; and Frank Opelka, MD, FACS...

Policy Snapshot
May 9, 2019

Pre-publication review and dispute for Program Year 2018 Open Payments data closes May 15. The Centers for Medicare & Medicaid Services (CMS) will publish Program Year 2018 data and updates to the previous program years in June.

Physician and teaching hospital review of the data is voluntary, but strongly encouraged. Here are a few things to know:

  • All records submitted during the submission period of the current calendar year are eligible for review and dispute, including newly edited, submitted, and re-attested records from previous calendar years; see the
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Policy Snapshot
May 9, 2019

Skilled Nursing Facility (SNF) Provider Preview Reports are available. 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 Centers for Medicare & Medicaid Services (CMS) review if you believe your data is inaccurate.

For more information:

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Policy Snapshot
May 9, 2019

The Centers for Medicare & Medicaid Services (CMS) added secure access to the Quality Payment Program Eligibility & Reporting page for the following Alternative Payment Models (APMs): Shared Savings Program, Next Generation Accountable Care Organization, and Comprehensive Primary Care Plus. The new capabilities allow APM entities to download a list of their clinicians.

For more information:

Policy Snapshot
May 2, 2019

The April 2019 Nursing Home Compare refresh is available, including quality measure results based on Skilled Nursing Facility (SNF) Quality Reporting Program data. Visit the Nursing Home Compare website to view the data. For more information, visit the SNF Quality Public Reporting ...

Policy Snapshot
May 2, 2019

The submission deadline for the Inpatient Rehabilitation Facility (IRF), Long-Term Care Hospital (LTCH), and Skilled Nursing Facility (SNF) Quality Reporting Programs for the fourth quarter of 2018 is May 15.

For more information:

Policy Snapshot
May 2, 2019

CMS Primary Cares Initiative: Direct Contracting Model Webinar — May 7

The CMS Primary Cares Initiative is a new set of payment models that will transform primary care to deliver better value for patients throughout the health care system. Direct contracting is a set of three voluntary payment model options aimed at reducing expenditures and preserving or enhancing quality of care for beneficiaries in Medicare fee-for-service. These payment model options create opportunities for a broad range of organizations.

During the webinar—which is being held May 7...

Policy Snapshot
April 25, 2019

Addressing interoperability and e-prescribing issues has been one of the Societies advocacy goals over the last several years. As part of those efforts, last week several Society leaders and staff participated in a daylong strategy meeting to address challenges around e-prescribing and medication management. The National Council on Prescription Drug Programs (NCPDP) held the meeting with representatives from electronic health record (EHRs) vendors from both acute and post-acute care, facilities, pharmacies, and clinicians to discuss challenges with the unique PALTC workflow for e-...

Policy Snapshot
April 25, 2019

This week, Department of Health and Human Services (HHS) Secretary Alex Azar and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced the CMS Primary Cares Initiative, a new set of payment models with a goal to transform primary care to deliver better value for patients throughout the health care system.

The CMS Primary Cares Initiative will provide primary care practices and other providers with five new payment model options under two paths: Primary Care First (PCF) and Direct Contracting (DC). The five payment model options are:

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Policy Snapshot
April 25, 2019

On April 19, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1718-P) for Fiscal Year (FY) 2020 that updates the Medicare payment rates and the quality programs for skilled nursing facilities (SNFs). This proposed rule is part of CMS’ continuing efforts to strengthen the Medicare program by better aligning payment rates for SNFs with the costs of providing care and increasing transparency so that patients are able to make informed choices.  Additionally, effective October 1, 2019, CMS will begin using a new case-mix model, the Patient...