Tag: CMS
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Medical Association Endorses Refinements to Improve MACRA
Since the enactment of the Medicare Access and CHIP Reauthorization Act, many organizations have worked with Congress and the Centers for Medicare and Medicaid Services to promote a smooth implementation of the two payment models. Although MACRA is an improvement over the flawed sustainable growth rate payment model, its implementation has been flawed. The Medical…
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Medical Association Signs on to Letter Targeting PA Requirements
The Medical Association recently joined the American Medical Association and 85 other national medical groups and state medical associations in sending a letter to the Centers for Medicare & Medicaid Services to urge CMS to provide guidance to Medicare Advantage plans on prior authorization processes through its 2020 Call Letter. In the jointly signed letter,…
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E/M Code Changes: A Deeper Dive at What Could be Coming for 2021
This is the second in a series of articles reviewing notable changes in the 2019 Physician Fee Schedule Final Rule and provides a deeper discussion of the potential changes to the E/M Coding regime scheduled to take effect in 2021. For the original article, please see Evaluating and Managing the E/M Codes for 2019 and…
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CMS Announces New Medicaid Opportunity to Expand Mental Health Treatment Services
The Centers for Medicare & Medicaid Services recently sent a letter to State Medicaid Directors outlining existing and new opportunities for states to design innovative service delivery systems for adults with serious mental illness and children with serious emotional disturbance. The letter includes a new opportunity for states to receive authority to pay for short-term…
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CMS Updates LCD Determination Process
On Oct. 3, 2018, the Centers for Medicare and Medicaid Services announced updates to Chapter 13 of the Medicare Program Integrity Manual, which deals with Local Coverage Determinations. According to CMS, the updates are intended to “increase transparency and patient engagement.”[1] These changes call for informal meetings with interested parties before a formal request is…
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Medical Association, AMA, Others Take a Stand on New CMS Rule
The Medical Association joined with the American Medical Association and more than 170 other organizations to support some components of CMS’ “Patients Over Paperwork” initiative, and say three of its components need to be enacted immediately to reduce “note bloat” redundancy, yet also to oppose a proposal to collapse payment rates for physician office visit services…
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HHS Seeks Comments on Easing Stark Law Burdens
The Centers for Medicare & Medicaid Services has requested public input on how the physician self-referral law, or Stark Law, may be interfering with care coordination. To help accelerate the transformation to a value-based system that includes care coordination, HHS has launched a Regulatory Sprint to Coordinated Care. The Regulatory Sprint is focused on identifying…
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Brookwood Baptist Medical Center Medicare Certification Extended
Brookwood Baptist Medical Center, the second largest hospital in the metro Birmingham area, received an 11th-hour reprieve Thursday night with regulators from the Centers for Medicare and Medicaid Services accepted the facility’s action, thus allowing the hospital to continue its Medicare and Medicaid billing privileges. However, the facility is not out hot water just yet.…
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CMS Releases Proposed Rule for 2019 Medicare Quality Payment Program
On July 12, the Centers for Medicare & Medicaid Services released its proposed policies for Year 3 (2019) of the Quality Payment Program via the Medicare Physician Fee Schedule Notice of Proposed Rulemaking. The provisions included in the NPRM are reflective of the feedback we received from many stakeholders, and continue to provide additional flexibilities to reduce burden…
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CMS Rebrands Meaningful Use to Highlight New Changes
As part of the annual Medicare payment update proposal, Centers for Medicare and Medicaid along with the Trump Administration plan to rebrand Meaningful Use to reduce burdens and unnecessary regulations while emphasizing data sharing across providers. The new Meaningful Use program, now called “Promoting Interoperability,” aims to reduce reporting measures and initiate a stronger push…