After finalizing the cancellation of its episode payment and cardiac rehabilitation incentive payment models, many were left wondering whether the Trump administration opposed all bundled payment models, or only those in which participation was mandatory. Today, these questions began to be answered as the Centers for Medicare & Medicaid Services (CMS) announced a new bundled payment program: […]
Read MoreOn January 9, 2017, the Senate Finance Committee held a hearing to consider the nomination of Alex Azar II to be the Secretary of Health and Human Services (HHS). This hearing follows the Senate Health, Education, Labor and Pensions (HELP) Committee nomination hearing on November 29, 2017. Mr. Azar has been nominated to replace Tom […]
Read MoreOn December 27, CMS issued a State Medicaid Director letter to explain new limitations on federal financial participation for durable medical equipment (DME) in Medicaid. Beginning on January 1, 2018 (as required by Section 5002 of the 21st Century Cures Act), federal reimbursement to states for DME expenditures in Medicaid will be limited to the […]
Read MoreOn December 7-8, 2017, the Medicare Payment Advisory Commission (MedPAC) held a public meeting that focused on payment adequacy in multiple health care. MedPAC annually looks at these payment adequacy issues and presents recommendations for each care setting. In addition, the meeting continued a prior discussion about developing an alternative to the Merit-based Incentive Payment […]
Read MoreOn Thursday, November 30, 2017, CMS a final rule that cancels the Episode Payment Models (EPMs) and Cardiac Rehabilitation (CR) Incentive Payment Model. The rule also makes participation in the Comprehensive Care for Joint Replacement (CJR) model optional for hospitals located in some areas of the country. The initial proposed rule was released in August […]
Read MoreOn November 29, 2017, the Senate Health, Education, Labor and Pensions (HELP) Committee held a courtesy hearing to consider the nomination of Alex Azar as Secretary of the U.S. Department of Health and Human Services (HHS). Mr. Azar has been nominated to replace Tom Price, who resigned as Secretary in late September of this year. […]
Read MoreThe Centers for Medicare & Medicaid Services (CMS) has released its much-anticipated Calendar Year (CY) 2018 Quality Payment Program (QPP) Final Rule. In this final rule, CMS details changes to both the Advanced Alternative Payment Models (APMs) track and the Merit-Based Incentives Payment System (MIPS) track of the QPP. CMS says it expects this program to, “Modernize […]
Read MoreOn November 2-3, 2017, the Medicare Payment Advisory Commission (MedPAC) held a public meeting covering a variety of topics. Much of the discussion focused on an alternative to the Merit-based Incentive Payment System (MIPS), telehealth services, and biosimilars. Continuing the discussion began at the previous public meeting, the Commission considered a possible alternative to MIPS. […]
Read MoreTonight, CMS released the final Medicare Physician Fee Schedule (MPFS) payment rule for 2018. CMS is finalizing an overall update to physician payments of +0.41%, and the 2018 conversion factor will increase by $0.10, to $35.99 from 2017’s $35.89. Read on for more news…. Coding Policy Change for Biosimilars In 2016, CMS finalized a policy […]
Read MoreThe Medicare Payment Advisory Commission (MedPAC) held their second public meeting of the current term on October 5-6, 2017. While no recommendations were presented, the topics discussed by the Commissioners indicate areas where MedPAC may offer recommendations during this term. The first session of the meeting looked at possible next steps for the Merit-based Incentive […]
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