Washington Update. Mollie Gelburd, JD - 1 -
|
|
- Nathan Lamb
- 5 years ago
- Views:
Transcription
1 Washington Update Mollie Gelburd, JD - 1 -
2 Agenda Political and regulatory environment Trending topics Medicare physician payment reform: Mid-year status report Practice executive s watch list: Remainder of 2017 Q&A - 2 -
3 - 3 -
4 American Health Care Act (AHCA), H.R.1628 GOP effort to repeal the Affordable Care Act Passed U.S. House of Representatives on May 4 - Vote tally: CBO score: 14 million more uninsured by 2018; 23 million by Read MGMA s letter to House leadership Senate drafted their own version(s), which failed to pass before August recess - Needed 50 votes to pass - 4 -
5 AHCA: Senate Outlook Better Care Reconciliation Act (BCRA) Failed in vote with Cruz amendment Obamacare Repeal Reconciliation Act (ORRA) AKA repeal only Failed in vote Health Care Freedom Act (HCFA) AKA skinny repeal Failed in vote - 5 -
6 What s Next for 2018? June 21: Deadline for insurers to participate in ACA exchanges August 16 - Aetna and Humana exiting exchanges Unknown: Pricing for exchange products - Uncertainty about whether this Administration will pay insurance subsidies (i.e., cost-sharing reduction payments) - Insurers expected to price uncertainty into premium increase requests
7 County by County Analysis of Projected Insurer Participation in Exchanges 0 carriers 1 carrier 2 carriers >3 carriers Source: CMS, 8/16/17-7 -
8 2017 Medicare Physician Fee Schedule And Other Trending Topics
9 2017 Medicare Service Updates Telehealth New covered codes for ACP, ESRD dialysis, critical care consultation; new POS code for distant site practitioners CCM & TCM New payments for complex cases, additional time; reduced billing requirements Prolonged Services New codes for non-face-to-face services & increased payment for patient-facing services Mental Health New billable codes for treating patients with dementia, behavioral health conditions, etc. Download MGMA s analysis of the 2017 PFS and brand new CCM resource - 9 -
10 Spotlight on Telehealth: Conditions for Medicare Reimbursement 1 Service is furnished by a physician or authorized practitioner via an interactive telecom system 2 To an eligible telehealth individual 3 Located in a telehealth originating site 4 Service being furnished is on the list of covered codes
11 Spotlight on Telehealth: Next Steps CONNECT for Health Act would lift several of Medicare s restrictive coverage requirements Contact Congress to show your support Read MGMA s letter HHS just announced it will begin auditing distant site claims without corresponding originating site claims Take steps to protect your practice now by: Reviewing Medicare guidance on telehealth billing Using HHS originating site eligibility analyzer
12 New Nondiscrimination Rule What is it? Section 1557 of the ACA prohibits discrimination on the basis of race, color, national origin, sex, age, or disability by building on existing federal civil rights laws. Most notable changes impact provision of language assistance services to limited English proficiency individuals Who does it impact? Most medical group practices (any practice that accepts federal financial assistance from any sources other than solely Medicare Part B, including Medicare Parts A or D, Medicaid, or Meaningful Use incentive payments) When? Final rule effective July 18, 2016, with notice requirements due by Oct. 16,
13 New Nondiscrimination Rule How do I comply?»formalize and document a language access plan (not required but suggested)»arrange for translation services»post a notice of nondiscrimination in English (can be combined with existing notices)»post taglines in the top 15 languages in your state in your physical office, website, and significant publications»practices with 15+ employees must designate compliance coordinator For more information, visit -
14 Sample Sec Tagline ATTENTION: If you speak [insert language], language assistance services, free of charge, are available to you. Call 1-xxx-xxx-xxxx (TTY: 1-xxx-xxx-xxxx)
15 Unprecedented False Claims Act Violation eclinicalworks ordered to pay a $155 million settlement to resolve allegations it misrepresented software capabilities to obtain certification and paid kick-backs. As part of its agreement with OIG, eclinicalworks must: Promptly notify customers of safety issues and include steps to mitigate patient safety risk Provide updated software to customers free of charge Transfer customer data to another EHR vendor upon request without penalties or charges According to this FAQ, CMS does not plan to audit providers who relied on flawed software for their attestation. The agency realizes providers relied on the software for accuracy and likely would have met the requirements using updated CEHRT
16 Data Breaches MGMA, AMA, AHA, and other stakeholders joined an HHS initiative to combat WannaCry, a global ransomware attack that impacted some US hospitals. To date there have been no reports of attacks on physician practices, but practice leaders should take steps to take to protect their practices, including: Cyber security action steps for medical practices Conducting a HIPAA Security risk assessment Keeping your operating system and antivirus software up to date Encrypting systems and files that contain patient information Instructing staff not to open s, attachments or links in s from unfamiliar senders Practices using Windows or older operating systems should be extra vigilant
17 Medicare Physician Payment Reform Q3 Status Report on MIPS and APMs
18 MACRA/Quality Payment Program Choose your own adventure MIPS APMs
19 MIPS Pick your Pace Options for 2017 Pick your pace All-in Report some data Definition Report full MIPS data for at least 90 consecutive days (up to a full year) Report 1 or more of the following for at least 90 consecutive days: - More than 1 quality measure - More than 1 improvement activity - More than 4 ACI base measures Test the program Report at least one of the following: - 1 quality measure; OR - 1 improvement activity; OR - 4 ACI base measures Do nothing Report no data ++ bonus + bonus neutral adjustment 4% penalty
20 MIPS Score ECs assigned final score of points based on performance in 3 categories Final score compared to a performance threshold set by CMS each year Scores above threshold result in a bonus; scores below threshold get a penalty Budget neutrality: bonuses must equal penalty pool 2017 Thresholds Exception: high performers receive additional bonus up to 10% each year through
21 Projected 2019 MIPS Payment Adjustments MIPS Payment Adjustment Factor 4% 3% 2% 1% 0% -1% -2% -3% -4% MIPS Performance Threshold Exceptional Performance Threshold MIPS Score
22 MIPS Group Reporting Entire practice gets same MIPS score Select 1 reporting mechanism per MIPS performance category Not every clinician needs to report data for every quality measure so long as data completeness requirements are met Only 1 clinician needs to attest to completing an improvement activitya
23 2017 MIPS Tips: Quality 2017 approved registry list and QCDR list now available Quality 60% Benchmarks for same measure vary by reporting mechanism Bonus points are awarded for all reported measures even if the measure not counted (up to the 10% cap) 3-point minimum, even if measures fail data completeness criteria Data completeness thresholds are based on the proportion of applicable patients, not the number of clinicians who report data
24 2017 MIPS Tips: Improvement Activities CMS will not be releasing more detailed activity-level specifications Criteria was purposefully kept broad to recognize ongoing efforts Supporting documentation is suggested for each activity Report via yes/no attestation in early 2018 Only one clinician needs to attest to completing an activity for a group to count it
25 2017 MIPS Tips: Advancing Care Information ACI 25% Report base measures via yes/no attestation or one-patient denominator in early 2018 Focus on health information exchange and patient access measures, which count as both base and performance measures Maximize bonus points for data you were already reporting in Meaningful Use (e.g., registry reporting)
26 2017 AAPMs About 10% of clinicians will participate in Advanced APMs in 2017 MSSP ACO Tracks 2 & 3 Next Generation ACOs Comprehensive ESRD Care (2-sided risk) Comprehensive Primary Care Plus Oncology Care Model (2-sided risk) Comprehensive Care for Joint Replacement (CEHRT track)
27 MIPS & APMs: Group Practice POV Positives Stable fee-for-service payment updates from which to launch MIPS andapms Resets penalties (Max. -9% PQRS, MU, VM) Leverages benefits of the group practice model 90-day MIPS reporting options (vs. full year) MIPS improvement activity category rewards practices for ongoing clinical improvement efforts Challenges Lack of actionable feedback Overly complex MIPS scoring methodology No MIPS risk-adjustment in 2017 Retains check-the-box measure reporting over clinical improvement Limited AAPM pathways
28 Physician Practice Action Steps Assess performance under past reporting programs Evaluate vendor readiness & costs (ask about 2015 CEHRT!) Protect yourself against a MIPS penalty Determine your MIPS goal; establish a reporting strategy Comply with deadlines (CAHPS, Web Interface, MSSP, etc.) Analyze data at year-end; hone final reporting strategy Engage in ongoing learning; keep an open mind in Check out MGMA s QPP participation checklist >>
29 MGMA Resources Washington Connection (mgma.com/washington) Weekly e-newsletter with breaking updates and everything you need to know from our nation s capital MACRA/QPP Resource Center (mgma.com/macra) Your one-stop shop for new resources & information - Downloadable MACRA slides - MACRA FAQs Dedicated MIPS/APMs e-group Get your questions answered and engage in a dialogue with your MGMA peers about all things MACRA
30 Regulatory Relief Opportunities 2017 MGMA. All rightsreserved
31 MGMA 2017 Regulatory Burden Survey MGMA conducted member research in July 2017 to better understand the cost and challenges of complying with federal government regulations Survey includes responses from 750 group practices, with largest representation from independent medical groups with 6-20 physicians >>Read more at mgma.com/regrelief The magnitude of regulatory demands on physicians forces medical group practices to needlessly focus precious time and resources on administrative tasks instead of patient care Dr. Halee Fischer-Wright, MD, MMM, FAAP, CMPE, President and CEO at MGMA
32 Top 5 Regulatory Burdens Percentage of respondents who rated the issue as very or extremely burdensome Medicare Quality Payment Program (MIPS/APMs) Lack of electronic attachments for claims and prior authorization 82% 74% Audits and appeals 69% Lack of EHR interoperability 68% Payer use of virtual credit cards 59%
33 This MIPS takes rocket scientists to be successful -MGMA Regulatory Relief Research participant, June MGMA. All rightsreserved
34 A reduction in Medicare s regulatory complexity would allow our practice to reallocate resources toward patient care. 13% disagree or strongly disagree 4% neutral 84% agree or strongly agree
35 Executive Order: 2-for-1 Regulations MGMA. All All rightsreserved. reserved.
36 Ways & Means Red Tape Relief House Committee is asking for ways to reduce regulatory and legislative burden in Medicare. MGMA is recommending: Stark law reform Repeal it entirely or increase flexibilities Reimburse practices for translation services provided to comply with Sec Validate and adjust CLFS rates after lab reporting period Reduce reporting burdens Decrease MIPS requirements Increase opportunities to participate in APMs
37 Practice Executive s Watch List: Remainder of MGMA. All rightsreserved
38 Legislative Watch List Health care reform in the Senate - What will happen after recess? Looming deadlines - Government budget expires Sept Deadline for CHIP reauthorization is Sept Exceptions process for outpatient therapy caps expires Dec. 31 CONNECT for Health Act, S Expands Medicare coverage for telehealth services and remote patient monitoring - MGMA letter of support and grassrootsadvocacy
39 Regulatory Watch List Proposed Rules: June or July Final rules: Oct. or Nov. 60-day comment period Proposed 2018 Physician Fee Schedule conversion factor payment update - Appropriate use criteria for imaging services Proposed regulation modifying MIPS and APMs for Scope and timeline for EHR certification requirements - Implementation of MIPS cost component - Potential ramping up of MIPS requirements
40 Key proposals would: Delay mandate to use 2015 CEHRT; 2018 MIPS and APMs proposed rule Offer new facility-based scoring option for hospital-based clinicians; Increase the low-volume threshold, excluding 63% of clinicians; Delay implementation of the cost component of MIPS; and Anticipate APM participation will double due to new MSSP Track 1+ and growth in existing models
41 MGMA Comments on 2018 QPP Proposal Permanently shorten quality & ACI reporting periods to 90 days Simplify MIPS redundencies by awarding cross-category credit Finalize proposed expansion of the low-volume threshold and refine how it applies to groups Finalize the proposal to allow MIPS and APMs to use 2014 or 2015 CEHRT in 2018 Streamline the ACI performance category Provide feedback about MIPS performance at least every quarter Overhaul advanced APM criteria and expand list of qualifying models Seek opportunity to adopt private sector payment models and PCMHs as advanced APMs >>Read MGMA s comments to CMS
42 2018 physician fee schedule proposed rule Key proposals would: Set 2018 Medicare payment rates; Delay the Appropriate Use Criteria program until 2019; Retroactively lower PQRS reporting requirements to six measures; Reduce Value-Based Payment Modifier penalties and hold groups harmless if they met minimum quality reporting requirements; and Seek input about opportunities to reduce regulatory burdens on physician practices >>Read MGMA s Regulatory Analysis on 2018 MIPS/APMs and PFS Proposed Rules
43 2017 MGMA. All All rightsreserved. reserved MGMA: Your Voice in Washington MGMA and coalition express concern over planned implementation of the Social Security Number Removal Initiative (SSNRI) MGMA calls on CMS to pilot test episode-based cost measures MGMA signs onto letter urging delay of lab reporting under PAMA MGMA submits letter to FCC defending practice billing communications MGMA calls for delay in EHR certification mandates
44 Thank you
Washington Update. Suzanne Falk, MPP Associate Director, Government Affairs
Washington Update Suzanne Falk, MPP Associate Director, Government Affairs sfalk@mgma.org Agenda 2017 Medicare Physician Fee Schedule Highlights Miscellaneous Updates 2016 Quality Reporting Wrap-Up Quality
More informationWashington Update. Suzanne Falk, MPP Associate Director, Government Affairs
Washington Update Suzanne Falk, MPP Associate Director, Government Affairs sfalk@mgma.org Agenda 2017 Medicare Physician Fee Schedule Changes Miscellaneous Updates 2016 Quality Reporting Wrap-Up MACRA
More information4/8/17. The Changing Nature of Physician Payment and Health Care Reform in The AMA A Unifying Voice for Physicians
The Changing Nature of Physician Payment and Health Care Reform in 2017 U of Mo Family Medicine Update April 7, 2017 David Barbe, MD MHA President-elect American Medical Association VP Regional Operations
More informationMedicare Quality Payment Program Overview (MACRA)
Medicare Quality Payment Program Overview (MACRA) December 2016 Rev. 12/1/16 Some general observations MACRA is complex More than a replacement for the SGR Many of the new requirements are revisions to
More informationProposed 2018 Medicare Physician Payment and Quality Reporting Changes. Executive s Insights
Proposed 2018 Medicare Physician Payment and Quality Reporting Changes MGMA MEMBER-EXCLUSIVE ANALYSIS The Centers for Medicare & Medicaid Services (CMS) recently proposed changes to both Medicare physician
More informationMACRA: THE FINAL RULE. Last updated 12/13/16
MACRA: THE FINAL RULE Last updated 12/13/16 1 Background April 2015 MACRA (Medicare Access & CHIP Reauthorization Act) is signed into law to repeal the sustainable growth rate (SGR) which drastically cut
More informationMedicare Releases Final Rule for the Second Year of the Quality Payment Program
Medicare Releases Final Rule for the Second Year of the Quality Payment Program On Nov. 2, 2017, CMS issued the Calendar Year 2018 Quality Payment Program (QPP) final rule for the second transition year
More informationPRIMER: MACRA and the Merit-based Incentive Payment System (MIPS) Tara O Neill Hayes January 31, 2016
PRIMER: MACRA and the Merit-based Incentive Payment System (MIPS) Tara O Neill Hayes January 31, 2016 Background On April 16, 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) was signed into
More information2018 Washington Update
2018 Washington Update Drew Voytal, MPA Associate Director MGMA Government Affairs 2018 MGMA. All rights reserved. - 1 - - 2 - Agenda Current political and legislative environment Evolving federal payment
More informationThank you, and enjoy the webinar.
Disclaimer This webinar may be recorded. This webinar presents a sampling of best practices and overviews, generalities, and some laws. This should not be used as legal advice. Itentive recognizes that
More informationMACRA Final Rule Summary
MACRA Final Rule Summary On October 14, 2016, the Centers for Medicare and Medicaid Services (CMS) released its final rule implementing the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA),
More informationMACRA: New Medicare Reimbursement Models Sharp HealthCare
MACRA: New Medicare Reimbursement Models Sharp HealthCare August 15, 2016 Nathan M. Bays, Esq. General Counsel, The Health Management Academy Executive Director, Advisors Caitlin Greenbaum, MPH Director,
More informationYou Down with QPP? Daniel Collins Director of Finance Orlando Health Physician Enterprise
You Down with QPP? Daniel Collins Director of Finance Orlando Health Physician Enterprise Why Was the QPP created? Source: https://www.youtube.com/watch?v=7df7chghas4 What is QPP? Quality Payment Program
More informationScripps Health ACO Update
June 2016 Scripps Health ACO Update Marc Reynolds Senior Vice President, Payer Relations Scripps Health Anil N. Keswani, MD Corporate Vice President, Population Health Management Scripps Health 10 Key
More informationMACRA: Redefining How CMS Pays Doctors. White Paper ELLIS MAC KNIGHT, MD DAN KIEHL, JD CONTACT. Senior Vice President/CMO. Associate Consultant
MACRA: Redefining How CMS Pays Doctors White Paper ELLIS MAC KNIGHT, MD Senior Vice President/CMO DAN KIEHL, JD Associate Consultant June 2016 CONTACT For further information about Coker Group and how
More informationMEDICARE ACCESS AND CHIP REAUTHORIZATION ACT (MACRA) MERIT-BASED INCENTIVE PAYMENT SYSTEM (MIPS) REVIEW
MEDICARE ACCESS AND CHIP REAUTHORIZATION ACT (MACRA) MERIT-BASED INCENTIVE PAYMENT SYSTEM (MIPS) REVIEW I. MIPS Overview 1) Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) i) Signed into Law
More informationAAOS MACRA Proposed Rule Summary (Short)
AAOS MACRA Proposed Rule Summary (Short) Merit-Based Incentive Payment System (MIPS), Advanced Alternative Payment Model (APM) Incentive, and Criteria for Physician-Focused Payment Models Ref: CMS-5517-P
More informationCMS PROPOSES KEY PROVISIONS OF MACRA PHYSICIAN PAYMENT SYSTEM FOR 2019
Thursday, April 28, 2016 CMS PROPOSES KEY PROVISIONS OF MACRA PHYSICIAN PAYMENT SYSTEM FOR 2019 The Centers for Medicare & Medicaid Services (CMS) late yesterday issued a proposed rule implementing key
More informationHealth Care Policy Landscape: Market Trends & Frontline Perspectives
Health Care Policy Landscape: Market Trends & Frontline Perspectives December 1, 2016 www.leavittpartners.com Post-Election, New Administration Insights Top 10 Health Policy Actions to Watch 1 2 3 4 Substantial
More information2018 Merit-Based Incentive Payment System (MIPS) Scoring Overview
The Physicians Advocacy Institute s Medicare Quality Payment Program (QPP) Physician Education Initiative 2018 Merit-Based Incentive Payment System (MIPS) Scoring Overview 1 P a g e MEDICARE QPP PHYSICIAN
More information2018 Quality Payment Program Final Rule. Summary
Summary On Thursday, November 3, 2017, CMS issued the 2018 Quality Payment Program (QPP) final rule. Comments on the final rule are due January 1, 2018. The QPP encompasses the Merit-based Incentive Payment
More informationCopyright Scottsdale Institute All Rights Reserved.
Copyright Scottsdale Institute 2017. All Rights Reserved. No part of this document may be reproduced or shared with anyone outside of your organization without prior written consent from the author(s).
More informationMedicare Access and CHIP Reauthorization Act of 2015 (HR. 2; MACRA)
Fact Sheet April 23, 2015 H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Background. The Medicare Sustainable Growth Rate formula (SGR), passed by Congress in 1997, was intended to
More informationAMERICAN COLLEGE OF GASTROENTEROLOGY MAKING $ENSE OF MACRA
AMERICAN COLLEGE OF GASTROENTEROLOGY 6400 Goldsboro Road, Suite 200, Bethesda, Maryland 20817-5842; P: 301-263-9000; F: 301-263-9025 MAKING $ENSE OF MACRA CMS.SGR MACRA MIPS APMs QCDRs ACOs Why does Washington
More informationKey Financial and Operational Impacts from the Proposed Rule to Implement MACRA:
Key Financial and Operational Impacts from the Proposed Rule to Implement MACRA: The proposed rule implementing Access and CHIP Reauthorization Act of 2015 (MACRA) was made available on May 9, 2016. A
More informationQUALITY PAYMENT PROGRAM YEAR 3 (2019) FINAL RULE OVERVIEW NOVEMBER 15, 2018
QUALITY PAYMENT PROGRAM YEAR 3 (2019) FINAL RULE OVERVIEW NOVEMBER 15, 2018 Disclaimers This presentation was prepared as a tool to assist providers and is not intended to grant rights or impose obligations.
More informationTopics to be covered. Do I have to participate in MACRA/MIPS/QPP? Choices for participation. Timelines. What is changing with QPP
Topics to be covered Do I have to participate in MACRA/MIPS/QPP? Choices for participation Timelines What is changing with QPP I have no relevant financial relationships to disclose. Participant engagement
More informationAMERICAN COLLEGE OF GASTROENTEROLOGY MAKING $ENSE OF MACRA
AMERICAN COLLEGE OF GASTROENTEROLOGY 6400 Goldsboro Road, Suite 200, Bethesda, Maryland 20817-5842; P: 301-263-9000; F: 301-263-9025 MAKING $ENSE OF MACRA CMS.SGR MACRA MIPS APMs QCDRs ACOs Why does Washington
More informationGet Straight on MACRA in 2018
Quality Reporting Roundtable Get Straight on MACRA in 2018 FAQs, Advisory Board Guidance, and Resources Ye Hoffman, MS, CPHIMS Consultant March 27, 2018 research technology consulting 2 Manage Your Audio
More informationThe Future Of Medicare Physician Reimbursement
Portfolio Media. Inc. 111 West 19 th Street, 5th Floor New York, NY 10011 www.law360.com Phone: +1 646 783 7100 Fax: +1 646 783 7161 customerservice@law360.com The Future Of Medicare Physician Reimbursement
More informationCY 2018 Quality Payment Program Final Rule Summary
CY 2018 Quality Payment Program Final Rule Summary On November 2, 2017, the Centers for Medicare and Medicaid Services (CMS) released its final rule outlining the requirements for year two of the Quality
More informationMACRA: Alternative Payment Models Proposed Rule CY 2016
powered by Vizient & AAMC MACRA: Alternative Payment Models Proposed Rule CY 2016 June 2, 2016 Page 1 Housekeeping When you called in, did you enter your attendee ID number? Dial-in number: 1-866-469-3239
More informationMIPS and Health Information Technology: An Update for Medical Groups
MIPS and Health Information Technology: An Update for Medical Groups Richmond MGMA Jan. 18, 2018 Robert Tennant Director, Health Information Technology Policy Medical Group Management Association rtennant@mgma.org
More informationQUALITY PAYMENT PROGRAM YEAR 3 (2019) FINAL RULE OVERVIEW
QUALITY PAYMENT PROGRAM YEAR 3 (2019) FINAL RULE OVERVIEW NEAL LOGUE, HEALTH INSURANCE SPECIALIST, DIVISION OF FINANCIAL MANAGEMENT & FEE FOR SERVICE OPERATIONS DECEMBER 12, 2018 Disclaimers This presentation
More informationMACRA and the Evolving Health Care Landscape. Jarrod Fowler, M.H.A. FMA Director of Health Care Policy and Innovation
MACRA and the Evolving Health Care Landscape Jarrod Fowler, M.H.A. FMA Director of Health Care Policy and Innovation MACRA The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Passed Congress
More informationQuality Payment Program Year 3
Quality Payment Program Year 3 Final Rule Overview The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate (SGR) formula for clinician payment, and established
More informationFederal Update Issues Impacting Rheumatologists and their Patients. Emily L. Graham, RHIA, CCS-P VP, Regulatory Affairs Hart Health Strategies, Inc.
Federal Update Issues Impacting Rheumatologists and their Patients Emily L. Graham, RHIA, CCS-P VP, Regulatory Affairs Hart Health Strategies, Inc. Just a spoon full of DC? Agenda MACRA & Rheumatology
More informationMACRA: APPLICATIONS & IMPLICATIONS September 13, /13/2016. Mark Blessing, CPA, FHFMA Partner
MACRA: APPLICATIONS & IMPLICATIONS September 13, 2016 Mark Blessing, CPA, FHFMA Partner mblessing@bkd.com Zach Remmich Managing Consultant zremmich@bkd.com 1 TO RECEIVE CPE CREDIT Participate in entire
More informationQuality Payment Program Year 2
Quality Payment Program Year 2 MIPS Highlights Raising the performance threshold to 15 points in Year 2 (from 3 points in the transition year). Allowing the use of 2014 Edition and/or 2015 Certified Electronic
More informationA PRIMER FOR PRIMARY CARE
MACRA / MIPS Transition to value-based payment in Medicare A PRIMER FOR PRIMARY CARE Robert Resnik MD MBA Source: CMS What does MACRA Accomplish? Repeals the Sustainable Growth Rate (SGR) Formula Changes
More informationMACRA Update: The Top 8 For Amy Mullins, MD, CPE, FAAFP Medical Director, Quality Improvement AAFP
MACRA Update: The Top 8 For 2018 Amy Mullins, MD, CPE, FAAFP Medical Director, Quality Improvement AAFP Disclosure Statement It is the policy of the AAFP that all individuals in a position to control content
More informationHealth IT Public Policy Update
Health IT Public Policy Update January 21, 2016 Tom Leary HIMSS Vice President Government Relations HHS Set Firm Goals for the Move to Value-Based Care Health Information Technology for Economic and Clinical
More informationMACRA, MIPS, APMs & CPC+: What to Expect from All These Acronyms?! Monthly National Briefing April 26, 2016
MACRA, MIPS, APMs & CPC+: What to Expect from All These Acronyms?! Monthly National Briefing April 26, 2016 1 Shari Erickson, MPH Vice President, Governmental Affairs & Medical Practice American College
More informationMoving to Accountable Care through the ACA & MACRA
Moving to Accountable Care through the ACA & MACRA Jim Whitfill, MD President Lumetis, LLC Clinical Associate Professor, Departments of Internal Medicine and Biomedical Informatics University of Arizona
More informationOther Payer Advanced APM Determination
Other Payer Advanced APM Determination Process: CMS Multi-Payer Models Quality Payment Program Final Rule for Year 2 On November 2, 2017, the Department of Health and Human Services (HHS) issued a final
More information9/7/17. MACRA: The Knowns and the Unknowns. Disclosures. Goals and Objectives
MACRA: The Knowns and the Unknowns Sharon K. Merrick, M.S., CCS-P Director of Payment and Practice Management American Society of Anesthesiologists Wisconsin Society of Anesthesiologists September 10,
More informationNAACOS Analysis Shows ACOs In Top MIPS Performance Tier
NAACOS Analysis Shows ACOs In Top MIPS Performance Tier The National Association of Accountable Care Organizations (NAACOS) is sharing results of its analysis of ACO performance in the Quality Payment
More informationMACRA Medicare Payment Reform and the Implications to Medicare Advantage Plans
BEYOND THE NUMBERS MACRA Medicare Payment Reform and the Implications to Medicare Advantage Plans True BUSINESS PowerPoint Presentation Template November 2018 PRESENTED BY Bob Moné, FSA, MAAA Liz Myers,
More informationThe MACRA Proposed Rule on MIPS and APMs: Summary and Key Takeaways
The MACRA Proposed Rule on MIPS and APMs: Summary and Key Takeaways A White Paper May 2016 Impact Advisors LLC 400 E. Diehl Road Suite 190 Naperville IL 60563 1-800- 680-7570 Impact- Advisors.com Executive
More informationMACRA: How the 2018 Quality Payment Program Final Rule Impacts Providers
Medical Group Strategy Council MACRA: How the 2018 Quality Payment Program Final Rule Impacts Providers Rob Lazerow Managing Director Tony Panjamapirom Senior Consultant Hamza Hasan Practice Manager Julie
More informationSummary of the Quality Payment Program (QPP) Year 2 Final Rule
November 8, 2017 Summary of the Quality Payment Program (QPP) Year 2 Final Rule Medicare Program; CY 2018 Updates to the Quality Payment Program; and Quality Payment Program: Extreme and Uncontrollable
More informationA Practical Discussion of Value and Quality Based Payments What Do I Do Now?
Emerging Challenges in Primary Care: 2016 A Practical Discussion of Value and Quality Based Payments What Do I Do Now? Modified from AHLA Physicians and Hospitals Law Institute 2016 Faculty Ellie Bane
More informationOn Track for MACRA The Provider s Guide to QPP
On Track for MACRA The Provider s Guide to QPP Bizmatics, Inc. 4010 Moorpark Avenue, Suite 222 San Jose, CA 95117 www.prognocis.com training@bizmaticsinc.com Copyright 2017 Bizmatics, Inc. Overview CMS
More informationMedicare Red Tape Relief Project Submissions accepted by the Committee on Ways and Means, Subcommittee on Health
Please Provide Responses to the Fields Below Electronically to be Accepted Medicare Red Tape Relief Project Submissions accepted by the Committee on Ways and Means, Subcommittee on Health Date: August
More informationFinal Policy, Payment, and Quality Provisions in the Medicare Physician Fee Schedule for Calendar Year 2018
Final Policy, Payment, and Quality Provisions in the Medicare Physician Fee Schedule for Calendar Year 2018 Date 2017-11-02 Title Contact Final Policy, Payment, and Quality Provisions in the Medicare Physician
More informationPredictive Qualifying Alternative Payment Model (APM) Participants (QPs) Methodology Fact Sheet What is the Predictive QP Status Analysis?
Predictive Qualifying Alternative Payment Model (APM) Participants (QPs) Methodology Fact Sheet What is the Predictive QP Status Analysis? One of the Quality Payment Program s goals is to be clear about
More informationDEPARTMENT OF HEALTH AND HUMAN SERVICES & 42 CFR 414 [CMS-5522-FC
Executive Summary DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 414 [CMS-5522-FC and IFC] RIN 0938-AT13 Medicare Program; CY 2018 Updates to the Quality Payment
More informationEverything You Need to Know About the MIPS Payment Adjustment
Everything You Need to Know About the MIPS Payment Adjustment Sandy Swallow and Michelle Brunsen June 12, 2018 1 This material was prepared by Telligen, the Medicare Quality Innovation Network Quality
More information2018 Quality Measure Benchmarks Overview
2018 Quality Benchmarks Overview What Are Quality Benchmarks? When a clinician or group submits measures for the Merit-based Incentive Payment System (MIPS) quality performance category, each measure is
More informationMarch 1, Chairman Lamar Alexander United States Senate Committee on Health, Education, Labor, and Pensions Washington, DC 20510
March 1, 2019 Chairman Lamar Alexander United States Senate Committee on Health, Education, Labor, and Pensions Washington, DC 20510 Dear Chairman Alexander: On behalf of AMGA and our members, I appreciate
More informationMACRA Overview. April 2016
MACRA Overview April 2016 CMS is Focused on Progression from Volume-Based to Value-Based Payments Hospitals have some value-based payment via Hospital VBP, readmissions, and HAC programs Other provider
More information2018 Final Rule from CMS for the Quality Payment Program
2018 Final Rule from CMS for the Quality Payment Program Starting at Noon EST Wed 12/6/2017 Dr. Dan Mingle Register for Webinars or Access Recordings http://mingleanalytics.com/webinars 2017 Mingle Analytics
More information9/23/2016. Our Services. Transitioning from Fee-for-Service to Value-based Reimbursement. Key Trends and Strategies for Rural Health Providers
Transitioning from Fee-for-Service to Value-based Reimbursement Key Trends and Strategies for Rural Health Providers Paul MacLellan, CEO >> Health care consulting company >> Wholly owned subsidiary of
More informationMedicare s Shared Savings Program: Accountable Care Organizations Proposed Rule
Medicare s Shared Savings Program: Accountable Care Organizations Proposed Rule On March 31, 2011, the Centers for Medicare and Medicaid Services (CMS) issued its proposed rule on Medicare s Shared Savings
More information5 critical issues for BPCI-A
REPRINT June 2018 John M. Harris Molly Johnson Amanda Brown healthcare financial management association hfma.org 5 critical issues for BPCI-A Many hospitals and health systems may benefit from participation
More informationNew Medicare Merit-Based Incentive Payment System: Navigating Changes Under MACRA
Presenting a live 90-minute webinar with interactive Q&A New Medicare Merit-Based Incentive Payment System: Navigating Changes Under MACRA Overcoming Challenges in Transforming Payment and Care Delivery
More informationDecember 19, Dear Acting Administrator Slavitt:
December 19, 2016 Mr. Andrew Slavitt Acting Administrator Centers for Medicare & Medicaid Services U.S. Department of Health and Human Services Hubert H. Humphrey Building 200 Independence Avenue, S.W.
More informationAligning PQRS and Meaningful Use. Maximize your Medicare Reimbursement
Aligning PQRS and Meaningful Use Maximize your Medicare Reimbursement INTRODUCTION Brux McClellan, MPH, MHA Project Coordinator, HealthInsight Payment Adjustments Incentive $$ & Payment Adjustments Value
More informationRUPRI Center for Rural Health Policy Analysis. Rural Policy Brief. Brief No NOVEMBER
RUPRI Center for www.banko Rural Health Policy Analysis Rural Policy Brief Brief No. 2018-6 NOVEMBER 2018 http://www.public-health.uiowa.edu/rupri/ Changes to the Merit-based Incentive Payment System Pertinent
More informationKelly Brantley. Vice President Avalere Health
Kelly Brantley Vice President Avalere Health Health Policy Outlook Avalere Health An Inovalon Company February 8, 2018 Agenda 1 2 3 4 5 6 2017 Recap The Tax Cut and Jobs Act Individual Market Outlook Medicaid
More informationCMS released the 2018 Physician Fee Schedule Final Rule last week. The following is a summary of the AHRA-related policies.
CMS released the 2018 Physician Fee Schedule Final Rule last week. The following is a summary of the AHRA-related policies. 1. Appropriate Use Criteria Delayed Until 2020 CMS had already proposed to delay
More informationEight Indispensable Financial Considerations of Shifting from Volume to Value Reimbursement
Eight Indispensable Financial Considerations of Shifting from Volume to Value Reimbursement September 25-26, 2017 Max Reiboldt, CPA President CEO Learning Objectives This session will provide you with
More informationTitle I - Health Care Coverage
September 21, 2009 The Honorable Max Baucus Chairman, Senate Finance Committee 511 Hart Senate Office Building Washington, DC 20510 Dear Senator Baucus: On behalf of the American College of Physicians,
More informationHEALTH CARE INSIDER VOLUME 7 :: ISSUE 2 THE NEW REVENUE RECOGNITION STANDARD AS IT APPLIES TO HEALTH CARE ENTITIES
HEALTH CARE INSIDER VOLUME 7 :: ISSUE 2 In This Issue: The New Revenue Recognition Standard As It Applies To Health Care Entities Understanding The Transformation Of Medicare Physician Payments Health
More informationAugust 21, Ms. Seema Verma Administrator Centers for Medicare and Medicaid Services 7500 Security Boulevard Baltimore, Maryland
August 21, 2016 Ms. Seema Verma Administrator Centers for Medicare and Medicaid Services 7500 Security Boulevard Baltimore, Maryland 21244-1850 Dear Ms. Verma: On behalf of AMGA, we appreciate the opportunity
More informationPPACA and Health Care Reform. A Chronological Guide to Changes and Provisions Affecting Employee Benefits Plans and HR Administration
PPACA and Health Care Reform A Chronological Guide to Changes and Provisions Affecting Employee Benefits Plans and HR Administration AS OF 8/27/2013 Provisions Organized by Effective Date The Affordable
More informationACA Section 1557 Compliance: What it is, What it Does and What You Need to Know. Presented by: Anne M. Ruff
ACA Section 1557 Compliance: What it is, What it Does and What You Need to Know Presented by: Anne M. Ruff 317.977.1450 aruff@hallrender.com What is Section 1557 Who is Subject to Section 1557 What You
More information2019 Merit-based Incentive Payment System (MIPS) Quality Performance Category: Medicare Part B Claims Data Submission Fact Sheet
2019 Merit-based Incentive Payment System (MIPS) Quality Performance Category: Medicare Part B Claims Data Submission Fact Sheet The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the
More information2018 Merit-based Incentive Payment System (MIPS) Cost Performance Category Fact Sheet
2018 Merit-based Incentive Payment System (MIPS) Cost Performance Category Fact Sheet What is the Quality Payment Program? The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable
More informationHEALTH ECONOMICS AND REIMBURSEMENT
HEALTH ECONOMICS AND REIMBURSEMENT VASCULAR CY 2016 MEDICARE PHYSICIAN FEE SCHEDULE (PFS) UPDATE Abbott Vascular is pleased to provide you with this summary of the Medicare Physician Fee Schedule (PFS)
More information2018 Healthcare Industry Outlook:
2018 Healthcare Industry Outlook: What Providers Need to Know Chris Emper, JD, MBA January 17, 2018 ON24 Interface Your Presenter Chris Emper, JD, MBA President, Chris Emper, JD, MBA, is the founder and
More informationAdvancing Risk Capability in 2015: Medicare Shared Savings Program and ACO Investment Model. March 23, 2015 // 12:00 P.M. 1:00 P.M.
Advancing Risk Capability in 2015: Medicare Shared Savings Program and ACO Investment Model March 23, 2015 // 12:00 P.M. 1:00 P.M. EST CENTER FOR INDUSTRY TRANSFORMATION The DHG Healthcare Center for Industry
More informationAll About APMs: What Will It Take for Physicians to Earn the APM Bonus Under MACRA?
All About APMs: What Will It Take for Physicians to Earn the APM Bonus Under MACRA? By Robert F. Atlas, David B. Tatge, and Lesley R. Yeung June 2016 On May 9, 2016, the Centers for Medicare & Medicaid
More informationWHERE THE FRONT LINE MEETS THE BOTTOM LINE: THE HEALTHCARE SYSTEM OF THE FUTURE
WHERE THE FRONT LINE MEETS THE BOTTOM LINE: THE HEALTHCARE SYSTEM OF THE FUTURE AFT Nurses and Health Professionals Professional Issues Conference 2016 Fred Hyde, MD April 21, 2016 Trends for 2016-2022:
More informationFirst a word about the rising cost of retiree healthcare
Medicare Trends First a word about the rising cost of retiree healthcare The average 66-year-old couple is expected to spend nearly 60% of their Social Security income on medical bills, according to a
More informationVolume to Value The Great Transformation of American Medicine
Volume to Value The Great Transformation of American Medicine 2010-2020 Richard I. Fogel, MD FHRS Chief Clinical Officer St. Vincent Health October 2015 Fee for Service You get paid for what you do The
More informationCY 2014 Physician Quality Reporting System (PQRS)
CY 2014 Physician Quality Reporting System (PQRS) 101 Table of Contents Step 1: Understand PQRS and how it impacts you A. When was PQRS first established and implemented? B. What is PQRS? C. How does CMS
More informationMajor Provisions in the CY 2017 Medicare Physician Fee Schedule Proposed Rule Payment Policy
On July 15, 2016, the calendar year (CY) 2017 Medicare Physician Fee Schedule (PFS) Proposed Rule was published in the Federal Register. AGA, ACG and ASGE have developed this summary of key provisions
More informationH.R. 2: the Medicare Access and CHIP Reauthorization Act of Summary
H.R. 2: the Medicare Access and CHIP Reauthorization Act of 2015 Summary H.R. 2 (P.L. 114-10) became law on April 16, 2015. The law repeals and replaces the Medicare Sustainable Growth Rate (SGR) formula
More informationThe Road to Value. Aric R. Sharp, MHA, CMPE, FACHE Vice President Accountable Care UnityPoint Health February 3, 2017
The Road to Value Aric R. Sharp, MHA, CMPE, FACHE Vice President Accountable Care UnityPoint Health February 3, 2017 1,500 Physicians UnityPoint Clinic 17 hospitals + 15 rural network hospitals 35,000
More informationHealth care affordability VBC transformation
Health care affordability VBC transformation What s at stake? The cost of health care in the United States has been on an unsustainable rise for some time, driven by fundamental delivery and financing
More informationNext Generation Accountable Care Organization (ACO) Model Overview
The Physicians Advocacy Institute s Medicare Quality Payment Program (QPP) Physician Education Initiative Next Generation Accountable Care Organization (ACO) Model Overview Ad 1 P a g e MEDICARE QPP PHYSICIAN
More informationAffordable Care Act Repeal and Replacement Legislation
Affordable Care Act Repeal and Replacement Legislation Timeline/ Actions to Date In February 2017, draft legislation aimed at repealing and replacing the Affordable Care Act (ACA), or Obamacare, was informally
More informationSection 1557 of the Patient Protection and Affordable Care Act (ACA) and Regulations Issued by the U.S. Department of Health and Human Services (HHS)
Section 1557 of the Patient Protection and Affordable Care Act (ACA) and Regulations Issued by the U.S. Department of Health and Human Services (HHS) - Donald R. Moy Statute: Section 1557 of the ACA prohibits
More informationTrump Care: Overview of Healthcare Reform Plans
Trump Care: Overview of Healthcare Reform Plans Dan Schwebach, MHA, CPPM Vice President Copyright AAPC 2017 Affordable Care Act On Healthcare Today ACA Overview Main Objectives Expand Coverage - Reforming
More informationBENEFITS REQUIREMENTS
Client Name: No. of Employees: Note: This list is for use by employers with 50 or more employees. Plan Year: BENEFITS REQUIREMENTS Employer Payment Plans Prohibited. Ensure that an employer payment plan
More informationPREPARING FOR THE NEXT GENERATION OF MANAGED CARE CONTRACTING
PREPARING FOR THE NEXT GENERATION OF MANAGED CARE CONTRACTING Nanci Robertson, RN BSN President - Robertson Consulting, Inc. Doral Jacobsen, MBA FACMPE CEO - Prosper Beyond, Inc. DORAL JACOBSEN AND NANCI
More informationNo change from proposed rule. healthcare providers and suppliers of services (e.g.,
American College of Physicians Medicare Shared Savings/Accountable Care Organization (ACO) Final Rule Summary Analysis Category Final Rule Summary Change from Proposed Rule and Comments ACO refers to a
More informationThe ACA: Health Plans Overview
The ACA: Health Plans Overview Agenda What is the legal status of the ACA? Which plans must comply? Reforms currently in place 2013 compliance deadlines 2014 compliance deadlines 2015 compliance deadlines
More informationSeptember 6, Re: CMS-1600-P; CY 2014 Physician Fee Schedule Proposed rule comments
September 6, 2013 Centers for Medicare & Medicaid Services Department of Health and Human Services Attention CMS-1600-P Mail Stop C4-26-05 7500 Security Boulevard Baltimore, MD 21244-1850 Re: CMS-1600-P;
More information