Publications

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

MIPS Data Validation and Audit for Performance Years 2017 and 2018

Policy Snapshot
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
June 27, 2019

The Centers for Medicare & Medicaid Services (CMS) contracted with Guidehouse to conduct data validation and audits of some Merit-based Incentive Payment System (MIPS) eligible clinicians. Data validation and audits will help ensure MIPS is operating with accurate and useful data. MIPS-eligible clinicians, groups, and virtual groups are required by ...

CMS Proposes to Update e-Prescribing Standards

Policy Snapshot
Practice Management, Electronic Health Records (EHR), Practitioners
June 21, 2019

On June 17, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule  that would update the Part D e-prescribing program by adopting standards that ensure secure transmissions and expedite prior authorizations.

Under the proposed change, clinicians would be able to choose to complete prior authorizations online, reducing burden for...

REMINDER: Medicare Shared Savings Program: Submit Notice of Intent to Apply by June 28

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Accountable Care Organization (ACO), Practice Management, Practitioners
June 21, 2019

The Centers for Medicare & Medicaid Services (CMS) is accepting Notices of Intent to Apply (NOIAs) via the Accountable Care Organization Management System (ACO-MS) for a January 1, 2020, start date. You must submit a NOIA if you intend to apply to the BASIC or ENHANCED track of the Medicare Shared Savings Program, for a Skilled Nursing Facility (SNF) 3-Day Rule Waiver, and/or to establish and operate a Beneficiary Incentive Program:

  • NOIA submissions are due no later than June 28 at noon ET
  • A NOIA submission does
    • ...

MIPS Data Validation and Audit to begin June 2019 for Performance Years 2017 and 2018

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Merit-Based Incentive Program Payment System (MIPS), Quality Payment Program (QPP), Practice Management, Practitioners
June 21, 2019

The Centers for Medicare & Medicaid Services (CMS) has contracted with Guidehouse to conduct data validation and audits of a select number of Merit-based Incentive Payment System (MIPS) eligible clinicians.  Data validation and audits are processes that will help ensure MIPS is operating with accurate and useful data. MIPS-eligible clinicians, groups, and virtual groups are required by regulation to comply with data-sharing requests, providing all data as requested by CMS.

If you are selected for data validation and/or audit, you will receive a request for information from...

Society Active at the AMA’s 2019 House of Delegates: Report

Policy Snapshot
Dementia, Antipsychotics, Opioids, Alternative Payment Models (APM), Practitioners
June 14, 2019

Last week, first-time Society delegates Wayne Saltsman, MD, PhD, CMD, and Walter Lin, MD, MBA, attended the American Medical Association (AMA) House of Delegates meeting in Chicago, IL. The Society tracked and reviewed hundreds of resolutions submitted by state and specialty societies dealing with a variety of top policy issues. While the Society did not submit any resolutions for this year’s meeting, there were many that we monitored closely.

The American Association Geriatric Physiatry (AAGP) introduced resolution 708, “Access to Psychiatric Treatment in Long-Term Care.” The...

Medicare Shared Savings Program: Submit Notice of Intent to Apply by June 28

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Payment, Accountable Care Organization (ACO), Practice Management, Practitioners
June 14, 2019

The Centers for Medicare & Medicaid Services (CMS) is accepting Notices of Intent to Apply (NOIAs) via the Accountable Care Organization (ACO) Management System (ACO-MS) for a January 1, 2020, start date. You must submit a NOIA if you intend to apply to the BASIC or ENHANCED track of the Medicare Shared Savings Program, for a Skilled Nursing Facility (SNF) 3-Day Rule Waiver, and/or to establish and operate a Beneficiary Incentive Program:

  • NOIA submissions are due no later than June 28 at noon ET
  • An NOIA submission
    • ...

CMS Seeks Comments on Patients over Paperwork Initiative

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Patient Centered, Practitioners
June 14, 2019

The Centers for Medicare & Medicaid Services (CMS) created the Patients over Paperwork initiative to eliminate outdated, duplicative, and overly burdensome regulations so clinicians and providers can focus on their primary mission: patient care. Savings to providers and clinicians are estimated at $5.7 billion and 40 million burden hours through 2021. Estimated savings come from both final and proposed rules. This includes the elimination of 79 overly burdensome, redundant, or low-value measures for a projected savings of $128 million and anticipated reduction of 3.3 million burden...

Senators Release List of Poorly Performing Nursing Homes After Inquiry

Policy Snapshot
Centers for Medicare and Medicaid (CMS)
June 7, 2019

Recently the Centers for Medicare & Medicaid Services (CMS) responded to an inquiry from Sens. Bob Casey (D-PA) and Pat Toomey (R-PA) regarding underperforming nursing homes. CMS sent them a list of nursing homes with a recorded pattern of poor care and the senators released the information to the public along with a report and additional background information.

Under the Special Focus Facility (SFF) program, overseen by CMS, those facilities are made public; however, SFF...

Society Urges Congress to Further Improve MACRA

Policy Snapshot
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
June 7, 2019

In a letter sent this week to congressional leaders, the Society joined the American Medical Association and other national medical societies in urging Congress to make further refinements to improve the Medicare Access and CHIP Reauthorization Act (MACRA). The groups called on Congress to replace the 2020-2025 physician payment update freeze with positive payment adjustments for physicians, extend the Advanced APM bonus payments for an additional six years, and implement several additional technical improvements to MACRA.

MACRA included modest positive payment updates in the...

The Society Submits Comments on HIT Proposed Rule

Policy Snapshot
Electronic Health Records (EHR), Health Information Technology (HIT)
June 7, 2019

This week the Society submitted comments on the Centers for Medicare & Medicaid Services (CMS) proposed rule on the Medicare and Medicaid Programs, Issuers of Qualified Health Plans in the Federally-Facilitated Exchanges and Health Care Providers (proposed rule), and the Office of the National Coordinator for Health Information Technology (ONC) on the Interoperability, Information Blocking, and the ONC Health Information Technology (Health IT) Certification Program.

The Society supported the overall intent and direction of the proposed rule and pushed to ensure that...