Individualized Quality Control Plan for CLIA Laboratory Non-Waived Testing (May 19)

CMS is hosting a provider call on May 19, 2014 regarding the Clinical Laboratory Improvement Amendments (CLIA) Individualized Quality Control Plan (IQCP), which is a new, voluntary quality-control option for laboratories performing non-waived testing. The IQCP is intended to provide laboratories with more flexibility in customizing Quality Control (QC) policies and procedures according to test method and use, environment, and personnel competency.

CMS Call: National Partnership to Improve Dementia Care in Nursing Homes (May 20)

On May 20, 2014, CMS is hosting another call to discuss the National Partnership to Improve Dementia Care in Nursing Homes, which includes as a goal reducing the use of unnecessary antipsychotic medications in nursing homes. This call will focus on efforts to monitor enforcement rates and track surveyor training completion; the role that activity professionals play in the mission to improve dementia care; and nonpharmacologic care approaches.

CMS to Host Calls on Electronic Clinical Template for Home Health Orders

CMS is hosting a series of Special Open Door Forum calls to solicit feedback on data elements for a new “Suggested Electronic Clinical Template for Home Health.” Specifically, CMS seeks input on a list of clinical elements within a Suggested Electronic Clinical Template that would assist physicians when documenting the home health face-to-face encounter for Medicare purposes. Calls are scheduled for April 22, May 8, June 19, and July 16, 2014.

Highlights from Reed Smith's Post-Acute Care Conference

In early April, Reed Smith hosted an enlightening, industry-leading conference on post-acute care in Washington, D.C. The conference, entitled “Reed Smith 2014 Washington Health Care Conference: Focus on Post-Acute Care," brought together a panel of experts to discuss episodic care, bundling models, and alternative payment and delivery systems. The conference also featured other speakers who presented from the perspective of investors and Capitol Hill, along with a keynote address from American Enterprise Institute resident scholar Dr. Norman Ornstein.

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Reed Smith Hosting Washington Health Care Conference: Focus on Post-Acute Care on April 4, 2014 - One Week Left to Register

On April 4th, 2014, Reed Smith will host its inaugural Washington Health Care Conference at The Mayflower Renaissance Hotel in Washington, D.C. With a keynote from Dr. Norman Ornstein, this year’s conference will focus on post-acute care, bringing together leading industry professionals for a discussion on several important issues, including:

Governing in Polarized America: The Prospects for Policy in 2014 and Beyond (Keynote)

  • Dr. Norman Ornstein, Resident Scholar, American Enterprise Institute, and weekly columnist for National Journal and The Atlantic

Policy discussion on episodic care, bundling models, and alternative payment and delivery systems

  • Mike Cheek, Vice President for Medicaid and Long Term Care Policy, American Health Care Association
  • Judy Feder, Professor, Georgetown University McCourt School of Public Policy, and Urban Institute Fellow
  • Dr. Barbara Gage, Fellow, Managing Director, Engelberg Center for Health Care Reform, Brookings Institution
  • Dr. Vincent Mor, Ph.D., Florence Pirce Grant Professor of Community Health, Public Health Program, Brown University School of Medicine

Wall Street perspective: the current appetite for deals

  • Jay Barnes, Senior Vice President, Healthcare Investment Banking, Jefferies LLC

Hill briefing on Medicare legislation

  • Cate McCanless, Senior Policy Advisor, Brownstein Hyatt Farber Schreck

Limited seating is still available for this complimentary program. If you are interested in registering, please email Lindsay Korenich at lkorenich@reedsmith.com. For more information about this conference, click here.

CMS Public Meeting on Clinical Lab Codes (July 14)

CMS is holding a public meeting on July 14, 2014 to receive comments on the appropriate basis for establishing payment amounts for new or substantially revised HCPCS codes being considered for Medicare payment under the clinical laboratory fee schedule for 2015. The meeting also provides a forum for those who submitted reconsideration requests regarding final determinations made last year on new test codes.

CMS Call: Applying for the 2015 Medicare Shared Savings Program (April 8)

 On April 8, 2014, CMS is hosting a call on how to prepare for the Medicare Shared Savings Program application process for the January 1, 2015 start date. Among other things, the call will cover accountable care organization (ACO) structure and governance, application key dates, and the Notice of Intent to Apply submission process.

MedPAC Meeting to Address Various Medicare Payment Policies (March 6-7)

On March 6-7, 2014, the Medicare Payment Advisory Commission (MedPAC) is meeting to discuss a number of Medicare payment and policy issues, including: site-neutral payments for select conditions treated in inpatient rehabilitation facilities and skilled nursing facilities; developing payment policies to promote the use of services based on clinical evidence; measuring quality in Medicare delivery systems; payment for primary care; aligning Medicare benchmarks across payment models; and Medicare Advantage risk adjustment.

FDA to Overhaul an OTC System That "Isn't Working"

This post was written by Kevin M. Madagan and Jillian W. Riley

The Food and Drug Administration (FDA) has just announced that it will hold a public hearing March 25 and 26, 2014 to obtain input on the Agency’s current process for reviewing over-the-counter (OTC) drugs. This is a significant advancement in FDA’s long-standing plan to overhaul the OTC drug system. According to the announcement, the Agency’s OTC drug review “needs a critical examination at this juncture to examine whether and how to modernize its processes and regulatory framework.”

Teeing up the importance of the public hearing, Dr. Janet Woodcock, the Director of FDA’s Center for Drug Evaluation and Research (CDER), informed the Wall Street Journal that the Agency was “looking for creative ideas about how to improve the process.”1 According to Dr. Woodcock, “The current system isn’t working well for the public or for us.”  Additional details are available after the jump.

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CMS Sets Dates for 2014 HCPCS Public Meetings

CMS has announced that it is holding series of meetings in May and June to discuss pending application for the 2015 Healthcare Common Procedure Coding System (HCPCS) update. The dates are as follows:

  • May 20 & 21, 2014 -- Drugs/Biologicals/Radiopharmaceuticals/Radiologic Imaging Agents
  • May 28, 2014 -- Supplies and Other
  • June 3, 2014 -- Durable Medical Equipment (DME) and Accessories; and Orthotics and Prosthetics (O&P).

Additional information, include preliminary coding determinations, will be posted in advance of each meeting.

FTC Workshop on Health Care Competition (March 20-21)

The Federal Trade Commission (FTC) has scheduled a workshop on March 20-21, 2014 to examine developments in the U.S. health care industry, including those related to implementation of health care reform legislation and other trends related to cost, quality, access, and care coordination. Specifically, the workshop will address the following five topics:

  1. Professional Regulation of Health Care Providers -- how accreditation, credentialing, licensure, and scope of practice rules may affect competition and consumers.
  2. Innovations in Health Care Delivery -- including retail clinics and telemedicine that may offer significant cost savings while maintaining or improving quality of care and expanding consumer access to care.
  3. Advancements in Health Care Technology – implications of technology such as electronic health care records, health data exchanges, technology platforms for health care payers and providers, and certain other consumer-oriented technological advances.
  4. Measuring and Assessing Quality of Health Care – how developments in measuring and assessing health quality may impact competition and health care choices.
  5. Price Transparency of Health Care Services – how improved price transparency impacts costs to consumers and its potential to facilitate price coordination among health care providers.

CMS to Host "Physician Compare Town Hall Meeting" (Feb. 24)

On February 24, 2014, CMS is hosting a town hall meeting to discuss the future of the Physician Compare website and how to improve the information presented to consumers. For instance, CMS is seeking feedback on additional measures that might help consumers identify quality care, and measures to accurately and completely represent the various Medicare specialties. CMS is also considering including additional information such as Board Certification and other medical qualifications.  Related resources are posted on the CMS website.  CMS is accepting written comments on this topic until March 3, 2014.

CMS Call on Partnership to Improve Dementia Care in Nursing Homes (Feb. 26)

On February 26, 2014, CMS is hosting a call to discuss the National Partnership to Improve Dementia Care in Nursing Homes, which includes as a goal reducing the use of unnecessary antipsychotic medications in nursing homes. This call will focus on the role of surveyors in the implementation of the partnership, the importance of leadership, and the correlation between proper pain assessment and antipsychotic medication use.

CMS Special Open Door Forum on Hospital Inpatient Criteria/2-Midnight Benchmark (Feb. 4)

 On February 4, 2014, CMS will host a follow-up Special Open Door Forum call on the two-midnight benchmark for inpatient hospital admissions included in the FY Medicare inpatient prospective payment system final rule. The call will provide an opportunity allow hospitals, practitioners, and other interested parties to ask questions on the physician order and physician certification, inpatient hospital admission and medical review criteria included in the new policy.

House Panel to Examine Medicare "Extenders" Policy

On January 9, 2014, the House Energy and Commerce Health Subcommittee is holding a hearing on “The Extenders Policies: What Are They and How Should They Continue Under a Permanent SGR (Sustainable Growth Rate) Repeal Landscape?” The so-called extenders are measures that secure the continuation of various temporary Medicare payment and policy revisions impacting hospitals, physicians, therapy providers, and certain other provider types that are routinely extended by Congress (most recently as part of the Pathway for SGR Reform Act).

Office of Medicare Hearings and Appeals (OMHA) Medicare Appellant Forum (Feb. 12)

On February 12, 2014, the HHS Office of Medicare Hearings and Appeals (OMHA) is hosting a forum to: provide updates to OMHA appellants on the status of OMHA operations; furnish information on OMHA initiatives designed to mitigate a growing backlog in the processing of Medicare appeals at the OMHA level of the administrative appeals process; and discuss measures that appellants can take to make the administrative appeals process work more efficiently.

CMS Call: ESRD Quality Incentive Program Payments (Jan. 15)

A January 15, 2015 CMS call will focus on the 2016 Medicare End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP). Among other things, the call will cover the final measures, standards, scoring methodology, and payment reduction scale that are applied to the payment year 2016 program.

CMS Call: 2-Midnight Benchmark for Inpatient Hospital Admissions (Jan. 14)

CMS is hosting a provider call on January 14, 2014 to discuss the Medicare inpatient hospital admission and medical review criteria (also known as the 2-Midnight Rule) included in the FY 2014 Medicare inpatient prospective payment system/long-term care hospital final rule. During the call, CMS will present case scenarios on the application of the rule to sample medical records and address frequently-asked questions received from providers.

CMS Town Hall Meeting on IPPS New Technology Add-on Payments (Feb. 12)

CMS is holding a meeting on February 12, 2014 to discuss fiscal year (FY) 2015 applications for add-on payments for new medical services and technologies under the Medicare hospital inpatient prospective payment system (IPPS). CMS invites interested parties to present their comments, recommendations, and data regarding whether the FY 2015 new medical services and technologies applications meet the substantial clinical improvement criterion. The deadline for registration and submission of presenter information is January 21, 2014.

Hospital Outpatient Payment (HOP) Advisory Panel Meeting - March 10-11, 2014

CMS has scheduled a meeting of the HOP Advisory Panel on March 10-11, 2014. Among other things, the panel will address: whether procedures within an APC group are similar both clinically and in terms of resource use; APC group weights; packaging of hospital outpatient prospective payment system services and costs; and the appropriate supervision level (general, direct, or personal) for individual hospital outpatient therapeutic services. Registration is required.

Older Entries

November 25, 2013 — CMS Call on Medicare Physician Quality Reporting in 2014 (Dec. 17)

November 25, 2013 — CMS Call Regarding the Medicare Physician Value-Based Payment Modifier (Dec. 3).

November 13, 2013 — CMS Call on IRF Quality Reporting Requirements (Nov. 14)

November 11, 2013 — CMS Call on Inpatient Hospital Admissions 2-Midnight Policy (Nov. 12)

November 11, 2013 — CMS Special Open Door Forum on LTCH Quality Reporting (Nov. 21)

November 11, 2013 — CMS Update on Medicare IVIG Demonstration (Nov. 22)

October 30, 2013 — CMS Call on Dementia Care in Nursing Homes (Nov. 25)

October 29, 2013 — CMS Call to Discuss Streamlined Access to PECOS, EHR, and NPPES (Nov. 15)

September 24, 2013 — CMS Call on Two Midnight Benchmark for Inpatient Hospital Admissions (Sept. 26)

September 12, 2013 — CMS Call on 2015 Value-Based Payment Modifier (Sept. 24)

August 27, 2013 — CMS Call on Draft Electronic Clinical Template for Lower Limb Prostheses (Sept. 11)

July 29, 2013 — CMS Call: ICD-10 Basics (Aug. 22)

July 29, 2013 — In Advance of Sunshine Act Reporting, CMS Releases Physician & Industry Resources

July 5, 2013 — CMS Call on EHR Incentive Program Clinical Quality Measures (July 23)

July 5, 2013 — CMS Call: PQRS Reporting and the Value-based Payment Modifier (July 25)

June 26, 2013 — HHS Seeks Comments on IRB Assessment of Risks in Standard of Care Interventions Research; Aug. 28 Meeting Scheduled

June 25, 2013 — CMS Call on PQRS Reporting and the Value-based Payment Modifier (July 31)

June 25, 2013 — CMS Call on Improving Dementia Care in Nursing Homes (July 10)

June 6, 2013 — CMS Call on Suggested Electronic Clinical Template for Lower Limb Prostheses (June 13)

June 6, 2013 — CMS Call on PQRS and eRx Incentive Program Payment Adjustment (June 18)

June 6, 2013 — CMS Hosts Calls on Medicare Shared Savings Program Application Process

June 6, 2013 — CMS Call on Medicare and Medicaid EHR Incentive Programs and Certified EHR Technology (June 27)

June 5, 2013 — HHS-Operated Risk Adjustment Data Validation Stakeholder Meeting (June 25)

June 5, 2013 — Advisory Panel on Hospital Outpatient Payment Meeting on August 26-27

June 5, 2013 — House SGR Reform Efforts Continue - Hearing Today

May 30, 2013 — CMS to Host July 10, 2013 Meeting on New Clinical Laboratory Test Payment Determinations

May 11, 2013 — Senate Finance Members Seek Physician Input on SGR Reform

May 8, 2013 — CMS Call on New Medicare Data Portal (May 16)

May 3, 2013 — CMS Sunshine Act Update: Covered Teaching Hospitals Listing, Industry Efforts, CMS Provider Call

April 15, 2013 — PCORI Comparative Effectiveness Data Infrastructure Event (April 23)

April 15, 2013 — CMS Meeting on Billing and Coding with Electronic Health Records (May 3)

April 8, 2013 — CMS Call: ESRD Low-Volume Payment Adjustment (April 24)

March 25, 2013 — CMS Call on Transitioning to ICD-10 in 2013 (April 18)

March 25, 2013 — CMS Call: PQRS Group Practice Reporting Option and Registry Reporting (April 16).

March 25, 2013 — CMS Call on Medicare Shared Savings Program Application Process (April 9 & 23)

March 13, 2013 — Implementation of Medicare Ordering/Referring Provider Edits (March 20 Call)

March 8, 2013 — CMS Call: "2013 PQRS and eRx Claims-Based Reporting Made Simple" (March 19)

March 8, 2013 — CMS Call: ESRD Quality Incentive Program (March 13)

March 8, 2013 — National Provider Call: Hospital Value-Based Purchasing FY 2015 Overview (March 14)

February 18, 2013 — CMS Announces Dates for 2013 HCPCS Public Meetings

February 18, 2013 — ICD-9-CM Coordination and Maintenance Committee Meeting (March 5, 2013)

February 15, 2013 — CMS Call: How to Avoid a 2014 eRx and 2015 PQRS Payment Adjustment (Feb. 19)

February 14, 2013 — March Meeting of the Advisory Panel on Hospital Outpatient Payment (March 11, 2013)

January 23, 2013 — CMS to Host Call on Future Development of the Quality Improvement Organization (QIO) Program (1/24)

January 14, 2013 — CMS Call to Focus on Improving Dementia Care in Nursing Homes (Jan. 31)

January 11, 2013 — CMS Call on Meaningful Use Stage 1 & 2 (Jan. 16)

January 11, 2013 — Access Board Committee to Meet on ACA Medical Diagnostic Equipment Standards (Jan. 22-23)

January 11, 2013 — FDA To Hold Workshop on Accessible Standardized Medical Device Labeling (April 29-30)

December 14, 2012 — PQRS and eRx Incentive Program National Provider Call (Dec. 18)

December 14, 2012 — CMS Call on ACA Medicare DSH Payment Provisions (Jan. 8, 2013)

December 5, 2012 — House Panel Schedules Hearing on Implementation of ACA's Exchanges and Medicaid Expansion (Dec. 13)

December 3, 2012 — CMS Medicaid Drug Pricing Webinar: Draft Federal Upper Limits and Draft Survey of Retail Prices (Dec. 5)

November 29, 2012 — CMS Schedules Feb. 5 Meeting on FY 2014 IPPS New Tech Add-on Applications

November 28, 2012 — Upcoming FDA Public Meeting: Framework for Pharmacy Compounding/State and Federal Roles (Dec. 19)

November 12, 2012 — MACPAC Meeting on Medicaid Policy Issues (Nov. 15)

November 12, 2012 — Meeting on ACA Medical Diagnostic Equipment Access Standards (Dec. 3-4)

October 31, 2012 — MedPAC Meeting on Medicare Policy Issues (Nov. 1-2)

October 15, 2012 — CMS Calls on IRF, LTCH Quality Reporting (Oct. 18)

October 15, 2012 — CMS Provider Call: PQRS Informal Review (Oct. 23)

October 11, 2012 — OIG to Host "Outlook 2013" Webcast (Oct. 24)

October 10, 2012 — IRS Schedules Hearing on Proposed Rules for Charitable Hospitals (Dec. 5)

October 8, 2012 — CMS Call on Medicare Provider Enrollment (Oct. 10)

September 27, 2012 — FDA Meetings on Patient-Focused Drug Development Initiative

September 25, 2012 — CMS Call: Manual Medical Review of Therapy Claims (Sept. 26)

September 24, 2012 — CMS Call: Preparing Physicians for ICD-10 Implementation (Oct. 25)

September 24, 2012 — CMS Call: Hospital Value-Based Purchasing for FY 2013 (Oct. 4).

September 24, 2012 — National Provider Call: Physician Quality Reporting System and E-Prescribing Incentive Program (Sept. 25)

September 24, 2012 — CMS Call on Medicare Prior Authorization for Power Mobility Devices Demonstration (Sept. 26)

September 24, 2012 — CMS to Host ASC Quality Reporting Webinar (Sept. 26)

September 12, 2012 — CMS Monthly Calls on ACA Provider Issues - Medicaid Expansion Call on Sept. 13

September 5, 2012 — CMS Call: Stage 2 Requirements for the Medicare/Medicaid EHR Incentive Programs (Sept. 13)

September 4, 2012 — PCORI Workshops on Research Topic Selection

September 4, 2012 — MedPAC Meeting on Medicare Policy Issues (Sept. 6-7)

August 31, 2012 — CMS Open Door Forum on Manual Medical Review of Therapy Claims (Sept. 5)

August 16, 2012 — IRS Schedules Nov. 9, 2012 Hearing on ACA Branded Prescription Drug Fee

August 16, 2012 — CMS Call to Focus on ACO Educational Opportunities (Aug. 27)

August 16, 2012 — CMS Forum on LTCH Quality Reporting (Aug. 30)

August 4, 2012 — CMS Announces August 27, 2012 Start Date for Recovery Audit Prepayment Review Demonstration; Provider Call Scheduled for Aug. 9

July 27, 2012 — CMS Provider Call on New Medicare Preventive Services (August 15)

July 25, 2012 — CMS Webinar: State Innovation Models Initiative Overview (July 26)

July 25, 2012 — CMS Call on Medicare Physician Value-Based Payment Modifier (Aug. 1)

July 25, 2012 — CMS Call on Prior Authorization for Power Mobility Devices Demonstration (July 27)

July 25, 2012 — CMS Forum: Improving Care for Medicare Beneficiaries with ESRD (July 31)

July 25, 2012 — CMS Call: Medicare Shared Savings Program and Advance Payment Model Application Process (July 31)

July 25, 2012 — CMS Webinar on Retail Community Pharmacy Consumer Prices Survey (July 26)

July 20, 2012 — CMS Schedules Calls on IRF Quality Reporting Program

June 26, 2012 — CMS Officially Announces Potential Inherent Reasonableness Payment Adjustment for Medicare Retail Diabetic Testing Supplies; Meeting Set for July 23

June 23, 2012 — CMS Webinar on Medicaid National Average Drug Acquisition Cost Survey (June 28)

June 22, 2012 — CMS Call on Medicare Shared Savings Program and Advance Payment Model Application Process (July 16)

June 22, 2012 — National Provider Call: Hospital Value-Based Purchasing (July 11)

June 22, 2012 — CMS/ONC Call: Using Certified EHR Technology to Meet Meaningful Use (June 27)

June 13, 2012 — CMS Call on Prior Authorization for Power Mobility Devices (PMD) Demonstration (June 28)

May 29, 2012 — Hospital Outpatient Payment (HOP) Advisory Panel to Meet Aug. 27-29

May 29, 2012 — CMS Schedules July 16-17 Meetings on 2013 Medicare Clinical Lab Fee Schedule Updates

May 29, 2012 — CMS Call on Medicare & Medicaid EHR Incentive Programs (June 7)

May 23, 2012 — CMS Examining Inherent Reasonableness Payment Adjustment for Medicare Retail Diabetic Testing Supplies; Meeting Scheduled for July 23

May 10, 2012 — CMS Call on IRF PPS Coverage Requirements (May 31)

April 23, 2012 — IRS Notice on ACA Insurance Plans Fees to Fund Patient-Centered Outcomes Research Trust Fund

April 23, 2012 — CMS Call on Power Mobility Device Prior Authorization Demonstration (May 3)

April 23, 2012 — CMS Posts Draft Electronic Clinical Template for Documenting Power Mobility Device (PMD) Encounters