Tagged with APM Alternative Payment Models
CMS Issues Advanced Alternative Payment Model Incentive Payment Advisory
CMS has released a payment advisory alerting certain clinicians who are Qualifying APM participants (QPs) and eligible to receive an Advanced Alternative Payment Model (APM) Incentive Payment for 2019, that the agency does not have the current banking information needed to disburse the payment and provides information on how to update banking information to receive this payment.
Executive Order Issued to Protect Traditional Medicare and MA Plans
The president, on October 3, signed an executive order directing the Department of Health and Human Services to increase efforts to provide more insurance plan options under Medicare Advantage and to remove regulations that are considered burdensome to health care providers. The order is intended to protect traditional Medicare and private Medicare Advantage while ramping up alternative payment models, time spent with patients, access to innovative technology and reducing the regulatory burdens on providers.
CMS Issues FAQs on BPCI Advanced Model
CMS, on June 21, issued several new or updated frequently asked questions documents on the Bundled Payments for Care Improvement (BPCI) Advanced Model, an Advanced Alternative Payment Model launched last October that will run through 2023.
New Legislation Aims to Strengthen Stark Law
The Promoting Integrity in Medicare Act (PIMA) seeks to update Medicare policies by preventing self-referrals related to advanced imaging services, radiation therapy, anatomic pathology and physical therapy.
CMS Releases CY 2019 Physician Fee Schedule Final Rule
On November 1, CMS released its Medicare Physician Fee Schedule final rule for calendar year (CY) 2019. The latest update includes changes to the Quality Payment Program as well as documentation and payment adjustments for evaluation and management services.
New Data Shows 93% of Eligible Clinicians Received MIPS Payment Under QPP Last Year
New data released by CMS shows 93% of eligible clinicians who participated in the Merit-Based Incentive Payment System (MIPS) under the Quality Payment Program (QPP) received positive payment adjustments for their MIPS performance last year.
eCQM Value Set Update for 2019 Reporting and Performance Periods Published
CMS and the National Library of Medicine (NLM) has published the most recent updates to the electronic clinical quality measure (eCQM) value sets. The updated sets include ICD-10 Clinical Modification (CM) and Procedure Coding System (PCS), SNOMED CT, LOINC, and RxNorm.
AMA Issues Alternative Payment Model for Opioid Use Disorder Treatment
The American Medical Association (AMA) and the American Society of Addiction Medicine (ASAM) have announced plans to pilot test a model that includes medications combined with psychosocial support.
CMS Launches New Voluntary Bundled-Payment Model
CMS on January 8th introduced its new voluntary bundled payment model, Bundled Payments for Care Improvement Advanced (BPCI Advanced).
CMS Launches New QPP Data Submission System for Clinicians
CMS has launched a new data submission system for clinicians participating in the Quality Payment Program (QPP), designed to reduce administrative burdens and streamline the data submission process.
Insurers Praise Medicare Advantage Alternative Payment Models Demonstration Project
Providers and insurance groups are in favor of CMS’ plans to develop a demonstration project that will test the effects of allowing clinicians to receive credit for financial risk-based arrangements with Medicare Advantage (MA) plans.
CMS Announces Transition of eCQMs to CQL for CY2019 Reporting Periods
CMS, on October 31st, announced that electronic clinical quality measures (eCQMs) in CMS quality programs will be transitioned to use the Clinical Quality Language (CQL) standard (CQL Release 1, Standard for Trial Use (STU) 2) for logic expression. Additionally, CMS has issued revised technical release notes (TRNs) for the addendum to the electronic clinical quality measure (eCQM) annual update specifications for 4th Quarter 2017 reporting and 2018 reporting periods.
2018 eCQM Value Set Addendum for EPs, ECs Released
CMS has released an addendum to the electronic clinical quality measure (eCQM) annual update specifications originally published in May 2017. This addendum updates eCQM value sets for the 2018 performance period for Eligible Professionals (EPs) and Eligible Clinicians (ECs).
RI – Exchange Plan Rate Increases Approved for 2018
The Office of the Health Insurance Commissioner approved health insurance premium rates in Rhode Island for 2018 that include exchange plan rate increases ranging from 5% to 12.1% for 2018.
CMS Releases Quality Payment Program Proposed Rule
On June 20th, CMS released its 2018 Medicare Quality Payment Program (QPP) proposed rule. Officially titled, “CY 2018 Updates to the Quality Payment Program,” the rule includes key policy updates that seek to streamline reporting requirements and simplify participation under the Merit-Based Incentive Payment System (MIPS) [Track 1] and the Advanced Alternative Payment Model (Advanced APM) [Track 2] pathways created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
End-Stage Renal Disease Proposed 2018 Policy and Payment Rate Changes
CMS has issued a proposed rule that would update payment policies for the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS). The ESRD PPS proposed rule is one of several for CY 2018 that reflect a broader strategy to relieve regulatory burdens for providers; support the patient-doctor relationship in healthcare; and promote transparency, flexibility, and innovation in the delivery of care.
New Medicare Bundled Payment Models Delayed until 2018
CMS has delayed the start date of the new bundled payment program for heart attack, cardiac bypass, and hip and femur fracture episodes of care and the new cardiac rehabilitation incentive program. The agency also delayed several conforming changes to the existing Comprehensive Care for Joint Replacement (CJR) model until 2018.
CMS gives over 800K Physicians Reprieve from MACRA Reporting in 2017
CMS has sent over 800,000 letters to clinicians, with notification that they will not be evaluated under the MACRA Merit-based Incentive Payment System (MIPS) in 2017. Federal officials predict only about one-third of clinicians will have to file quality reports this year under the new Medicare payment system.
CMS Pediatric Care Improvement RFI Extension Announced
CMS announced that it will extend the deadline for comments on the Request for Information (RFI) seeking input on the design of alternative payment models (APMs) focused on improving the health of children and youth covered by Medicaid and CHIP through April 7.
2018 ACO Application Cycle Details Announced
CMS released key deadlines and other important application cycle details information for applying to become a Next Generation ACO or Medicare Shared Savings Program ACO with a 2018 start date.
