MedPAC Meeting on Medicare Policy (April 2-3, 2015)

 On April 2-3, 2015, the Medicare Payment Advisory Commission (MedPAC) is meeting to discuss various Medicare policy issues, including: hospital short stay policy; polypharmacy/multiple drug use (focusing on Part D opioid use); Medicare Part D risk sharing; measuring low-value care; using episode bundles to improve care efficiency (including potential refinements to the Medicare spending per beneficiary measure); bundling oncology services; and synchronizing Medicare policy across payment models.

CMS Calls on Next Generation ACO Model

CMS is hosting a series of calls to discuss its new “Next Generation” ACO Model, which is intended to promote Medicare quality improvement and care coordination. The following upcoming calls are scheduled:

March 31, 2015 -- Focusing on financial methodology and related issues;
April 7, 2015 – Focusing on benefit enhancements and beneficiary care coordination reward; and
April 14, 2015 – Focusing on letter of intent and application.

CMS Call on Reviewing Open Payments/Sunshine Act Data (April 15)

CMS is hosting a national provider call on April 15, 2015 to discuss the Open Payments program, including the process for physicians and teaching hospitals to review applicable data prior to publication.  Registration is required.

CMS Announces New "Next Generation" ACO Model; Schedules 3/17 Call

On March 10, 2015, CMS announced the Next Generation Accountable Care Organization (ACO) Model, its latest Affordable Care Act (ACA) innovation initiative intended to promote Medicare quality improvement and care coordination. The Next Generation ACO Model differs from the existing Medicare Shared Savings Program and Pioneer ACO models in several ways. For instance, the Next Generation ACO Model:

  • Provides higher levels of risk and reward, using what CMS characterizes as more stable, predictable benchmarking methods that reward both attainment and improvement in cost containment and that move away from comparisons to an ACO’s historical expenditures;
  • Offers a selection of payment mechanisms to shift from fee-for-service (FFS) reimbursement to capitation; and
  • Includes “benefit enhancement” tools to improve engagement with beneficiaries, including (1) greater access to home visits, telehealth services, and skilled nursing facilities; (2) opportunities to receive a reward payment for receiving care from the ACO; (3) a process to allow beneficiaries to confirm their care relationship with ACO providers; and (4) CMS-ACO collaboration to improve communication with beneficiaries about the potential benefits of ACOs.

CMS plans two rounds of applications for the Next Generation ACO Model in 2015 and 2016, with participation expected to last up to five years. Letters of Intent for the 2015 cycle are due May 1, 2015, and applications are due June 1, 2015.  CMS plans an “Open Door Forum” call to discuss the new model on March 17, 2015.

CMS Posts Deadlines for 2016 Medicare Shared Savings Program Application Cycle; Schedules Informational Calls

CMS is gearing up for the program year 2016 Medicare Shared Savings Program, under which physicians, hospitals, and certain other types of providers and suppliers may form Accountable Care Organizations (ACOs) to provide cost-effective, coordinated care to Medicare fee-for-service beneficiaries. CMS has posted the deadlines for applying to the program for 2016 (the notice of intent deadline is May 29, 2015, and the application deadline is July 31, 2015). In addition, CMS is hosting an April 7, 2015 call to discuss organizational structure and governance requirements, antitrust considerations, and the application process for January 2016 starters.  An April 21 call will cover ACO participant agreements, ACO participant lists, and beneficiary assignment. 

FDA to Host Clinical Outcome Assessments Public Workshop (April 1)

On April 1, 2015, the FDA is hosting a workshop entitled “Clinical Outcomes Assessment Development and Implementation: Opportunities and Challenges.” The workshop will update the public on ongoing efforts in the use of clinical outcome assessments (COAs), and plan for the future of COA development and utilization in drug development programs. The workshop will also discuss how to incorporate patient-centered outcome measures, standards for COA use, and collaborative processes for COA development and dissemination.  Interested parties may participate in person or via webcast. The registration deadline is March 27, 2015.

CMS Call on Physician Quality Reporting Programs (March 18)

On March 18, 2015, CMS is hosting a call to discuss how providers may report once across various 2015 Medicare Quality Reporting Programs, including the Physician Quality Reporting System (PQRS), the Medicare Electronic Health Record (EHR) Incentive Program, the Value-Based Modifier (VM) program, and the Medicare Shared Savings Program. Providers that satisfactorily report will avoid the 2017 PQRS negative payment adjustment, satisfy the Clinical Quality Measure component of the Medicare EHR Incentive Program, and satisfy requirements for the VM.

CMS Call on Home Health Clinical Templates (March 11)

On March 11, 2015, CMS is hosting a call to discuss paper and clinical templates intended to assist physicians and practitioners in documenting patient eligibility for Medicare home health benefits. In announcing the call, CMS notes that the fiscal year 2014 Comprehensive Error Rate Testing (CERT) program identified a high proportion of claims with inadequate documentation supporting the face-to-face encounter requirement. Additional CMS calls on the templates will be held on April 8 and May 6, 2015.

CMS Schedules May 2015 Meetings on HCPCS Applications

CMS has announced that it is holding series of meetings in May 2015 to discuss pending  Healthcare Common Procedure Coding System (HCPCS) applications. The meeting dates are as follows:

May 7 & 8 -- Drugs/Biologicals/Radiopharmaceuticals/Radiologic Imaging Agents
May 21 & 22 -- Supplies and Other
May 27 -- Durable Medical Equipment (DME) and Accessories; and Orthotics and Prosthetics (O&P)

Deadlines and instructions for speaker and general registration and submission of comments are set forth in a notice to be published tomorrow.  Additional information, include preliminary coding determinations, will be posted in advance of each meeting at the CMS HCPCS website

CMS Call on the Improving Medicare Post-Acute Care Transformation Act (Feb. 25)

CMS is hosting a call on Wednesday, February 25, to discuss implementation of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act).  The IMPACT Act requires the submission of standardized data by long-term care hospitals, skilled nursing facilities, home health agencies, and inpatient rehabilitation facilities. On the call, CMS will provide an overview of the requirements related to the use of standardized data for both the quality measures and the assessment instrument domains.  CMS will also accept comments on this topic. Additional information is posted on the CMS Impact Act web page.

CMS Hospital Industry Call Today to Focus on RAC Improvements

Today CMS is hosting an Open Door Forum call to discuss several Medicare developments impacting hospitals, including changes CMS has made to the recovery audit program to strengthen oversight, reduce the provider burden, and enhance program transparency. The call begins at 2:00 eastern.

CMS Schedules Provider Calls on Medicare Payment, Quality, Coding & Program Integrity Topics

CMS has scheduled a series of provider calls in February and March on the following topics:

FTC/DOJ Workshop on Health Care Competition (Feb. 24).

On February 24, 2015, the Federal Trade Commission and the Department of Justice Antitrust Division will hold a public workshop on health care provider organization and payment model developments that may affect competition in the provision of health care services. Topics for discussion include: accountable care organizations; alternatives to traditional fee-for-service payment models; trends in provider consolidation; provider network and benefit design strategies; and health insurance exchanges.  The government also will accept comments on specific questions related to health care competition until April 30, 2015.

CMS Open Payments Question & Answer Session (Jan. 15)

On January 15, 2015, CMS is hosting an Open Payments Question & Answer Session, at which the CMS “Open Payments team” will be available to respond to questions about the data refresh and the upcoming 2014 Open Payments program year.  CMS intends to conduct these sessions monthly in the future.

MedPAC Meeting on Medicare Policies (Jan. 15-16)

On January 15-16, 2015, the Medicare Payment Advisory Commission (MedPAC) is meeting to discuss a number of Medicare topics, including, among others: post-acute care trends; payment updates for a number of provider types; relative costs of Medicare Advantage, accountable care organizations, and fee-for-service Medicare; hospital short stay policy; and quality measurement. 

CMS Call: Medicare Quality Reporting Programs: Data Submission Process (Jan. 13)

On January 13, 2015, CMS is hosting a national provider call to provide an overview of the 2014 submission process for Medicare quality reporting programs, including the Physician Quality Reporting System (PQRS), Value-Based Payment Modifier, and the Electronic Health Record Incentive Program. This session will discuss how eligible professionals and PQRS group practices can earn the 2014 PQRS incentive and avoid the 2016 negative PQRS payment adjustment through these reporting mechanisms.

Upcoming FDA meeting on Next Generation Sequencing Technology (Feb. 20)

On February 20, 2015, the FDA is hosting a public workshop on “Optimizing FDA’s Regulatory Oversight of Next Generation Sequencing Diagnostic Tests.” The purpose of the workshop is to receive feedback from the community on FDA’s regulatory approach to diagnostic tests for human genetics or genomics using Next Generation Sequencing (NGS) technology. As pointed out in an FDA preliminary discussion paper, “NGS tests are unique among existing [in vitro diagnostics] in the amount of data that can be generated, the lack of an a priori definition of what will be detected, and the number of clinical interpretations that can be made from a single patient sample.” The FDA is considering several regulatory approaches to regulating NGS tests, including a standards-based approach to analytical performance of NGS tests and the use of centralized curated databases containing up-to-date evidence to support clinical performance.

MedPAC Meeting on Medicare Payment Updates (Dec. 18 & 19)

On December 18-19, 2014, the Medicare Payment Advisory Commission (MedPAC) is meeting to discuss payment adequacy and payment update recommendations for Medicare payment systems.

CMS Call on Adding Star Ratings to Medicare Home Health Compare (Dec. 17)

On December 17, 2014, CMS is hosting a Special Open Door Forum (SODF) call to allow stakeholders to provide feedback on the planned addition of star ratings to the Medicare.gov Home Health Compare web site. 

FDA Public Meeting on Regulatory Oversight of Laboratory Developed Tests (Jan 8-9)

The FDA has scheduled a public workshop on the “Framework for Regulatory Oversight of Laboratory Developed Tests'' on January 8 – 9, 2015. The purpose of the workshop is to discuss FDA's proposal for a risk-based framework for addressing the regulatory oversight of “laboratory developed tests,” a subset of vitro diagnostic devices intended for clinical use and designed, manufactured and used within a single laboratory. Among other things, the FDA will address LDT labeling considerations; clinical validity and intended use; enforcement discretion; adverse event reporting; quality system regulation; and procedural issues. The workshop registration deadline is December 12, 2014. FDA will accept comments related to the public workshop until February 2, 2015.

Older Entries

November 20, 2014 — CMS Town Hall Meeting on FY 2016 New Technology Add-on Payments (Feb. 3)

November 19, 2014 — CMS Call on Changes to Physician Quality Reporting Programs for 2015 (Dec. 2)

November 19, 2014 — CMS Call: Certifying Patients for the Medicare Home Health Benefit (Dec. 16)

November 18, 2014 — CMS Call: National Partnership to Improve Dementia Care in Nursing Homes (Dec. 9).

October 28, 2014 — Congressional Hearing on Government Response to Ebola Crisis (Nov. 6)

October 28, 2014 — CMS Open Door Forum on IRF Quality Reporting Program (Oct. 29)

October 23, 2014 — HHS Office of Medicare Hearings and Appeals (OMHA) Hosting Second Medicare Appellant Forum (Oct. 29)

October 21, 2014 — CMS Call on 2013 Physician Quality and Resource Use Reports (Oct. 23)

October 21, 2014 — Hospital Outpatient Payment Advisory Panel Meeting (March 9-10, 2015)

October 7, 2014 — MedPAC Meeting on Medicare Policy Issues (Oct. 9-10)

October 7, 2014 — HHS Workshop: Integrating Plans for Long-Term Services and Supports & Health Care Delivery through Health IT (Oct. 16)

October 3, 2014 — CMS Call: Transitioning to ICD-10 (Nov. 5)

October 3, 2014 — CMS Call: Hospital Appeals Settlement Update (Oct. 9)

October 3, 2014 — CMS Call on Hospital Compare/HCAHPS Star Ratings (Oct. 8)

October 2, 2014 — FDA Releases Final Medical Device Cybersecurity Guidance, Schedules Workshop on Topic

September 5, 2014 — CMS Call: How to Avoid 2016 Negative Payment Adjustments under Medicare Quality Reporting Programs

September 4, 2014 — CMS Offers Settlement to Acute Care Hospitals, CAHs to Resolve Patient Status Denial Appeals

August 20, 2014 — ICD-10-CM/PCS Coordination and Maintenance Committee Meetings (Sept. 23-24)

August 19, 2014 — FDA Public Hearing on the Implementation of Generic Drug User Fee Amendments (Sept. 17)

August 8, 2014 — CMS Call on Expanded Medicare Prior Authorization for Power Mobility Devices Demonstration (Aug. 12)

July 22, 2014 — FDA Meeting on Biomarker Development (Sept. 5)

July 1, 2014 — CMS Plans Series of Calls this Month on Medicare Dialysis Quality Programs

June 13, 2014 — CMS Call on Medicare DMEPOS, Ambulance Prior Authorization Initiatives (June 17)

June 2, 2014 — Open Payments/Sunshine Act: CMS Registration Overview Call

May 22, 2014 — FDA Workshop to Focus on 3-D Printing of Medical Devices

May 19, 2014 — House Panel to Consider Bundled Post-Acute Care, Cancer Care Payment Parity Bills

May 14, 2014 — House Panel to Examine Medicare Hospital Issues (May 20)

May 10, 2014 — Next CMS Hospital Outpatient Payment Advisory Panel Meeting Set for August 25-26

April 28, 2014 — Congressional Hearings this Week to Focus on Medicare Fraud, Telehealth

April 22, 2014 — Individualized Quality Control Plan for CLIA Laboratory Non-Waived Testing (May 19)

April 22, 2014 — CMS Call: National Partnership to Improve Dementia Care in Nursing Homes (May 20)

April 18, 2014 — CMS to Host Calls on Electronic Clinical Template for Home Health Orders

April 17, 2014 — Highlights from Reed Smith's Post-Acute Care Conference

March 25, 2014 — Reed Smith Hosting Washington Health Care Conference: Focus on Post-Acute Care on April 4, 2014 - One Week Left to Register

March 25, 2014 — CMS Public Meeting on Clinical Lab Codes (July 14)

March 24, 2014 — CMS Call: Applying for the 2015 Medicare Shared Savings Program (April 8)

March 3, 2014 — MedPAC Meeting to Address Various Medicare Payment Policies (March 6-7)

February 24, 2014 — FDA to Overhaul an OTC System That "Isn't Working"

February 24, 2014 — CMS Sets Dates for 2014 HCPCS Public Meetings

February 18, 2014 — FTC Workshop on Health Care Competition (March 20-21)

February 11, 2014 — CMS to Host "Physician Compare Town Hall Meeting" (Feb. 24)

January 30, 2014 — CMS Call on Partnership to Improve Dementia Care in Nursing Homes (Feb. 26)

January 28, 2014 — CMS Special Open Door Forum on Hospital Inpatient Criteria/2-Midnight Benchmark (Feb. 4)

January 6, 2014 — House Panel to Examine Medicare "Extenders" Policy

January 6, 2014 — Office of Medicare Hearings and Appeals (OMHA) Medicare Appellant Forum (Feb. 12)

January 6, 2014 — CMS Call: ESRD Quality Incentive Program Payments (Jan. 15)

January 6, 2014 — CMS Call: 2-Midnight Benchmark for Inpatient Hospital Admissions (Jan. 14)

December 9, 2013 — CMS Town Hall Meeting on IPPS New Technology Add-on Payments (Feb. 12)

December 9, 2013 — Hospital Outpatient Payment (HOP) Advisory Panel Meeting - March 10-11, 2014

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)