CMS has announced that it is holding a meeting of the Advisory Panel on Hospital Outpatient Payment on August 24-25, 2015. The purpose of the Panel is to advise HHS and CMS on the clinical integrity of the Ambulatory Payment Classification (APC) groups and their associated weights and hospital outpatient therapeutic services supervision issues. Presentation forms are due by July 24 and the meeting registration timeframe runs from June 29 through July 31, 2015. During the scheduled meeting, webcasting is accessible online.
CMS is hosting a Special Open Door Forum call on May 27, 2015 to discuss eliminating the Certificate of Medical Necessity (CMN) and Durable Medical Equipment (DME) Information (DIF) forms. Comments on the forms also can be sent to ReducingProviderBurden@cms.hhs.gov.
CMS is proceeding with the application process for the Medicare Shared Savings Program for the January 1, 2016 program start date. Applicants interested in participating must submit a Notice of Intent to Apply by May 29, 2015, and complete the application by July 31, 2015. A CMS call regarding the Shared Savings Program application review process is scheduled for June 9.
CMS is hosting a June 17, 2015 provider call to discuss the Hospice Quality Reporting Program and the new Hospice Item Set (HIS) Manual (V1.02). The target audience includes quality staff at Medicare-certified hospice programs, including quality and compliance staff, and Quality Assurance and Performance Improvement (QAPI) program coordinators.
CMS is hosting a call on June 18, 2015 to present strategies and resources to prepare for ICD-10 implementation. The call will also provide an overview of ICD-10-PCS Section X for new technologies, which will be used by hospitals.
On June 16, CMS is holding a call on the National Partnership to Improve Dementia Care and Quality Assurance and Performance Improvement (QAPI). The target audience for the call is consumer and advocacy groups, nursing home providers, the surveyor community, prescribers, professional associations, and other interested stakeholders.
On May 12, 2015, CMS is hosting a call that will provide an overview of all Medicare hospital inpatient quality reporting and value-based purchasing programs. Specifically, the call will cover: the Hospital Inpatient Quality Reporting (IQR) Program; the Hospital Value-Based Purchasing (HVBP) Program; the Hospital Acquired Condition Reduction Program (HACRP); the Hospital Readmission Reduction Program (HRRP); and the Electronic Health Records (EHR) Incentive Program. The target audience for this call is hospital administrators, executive-level leaders, quality professionals, and staff new to quality reporting programs. Registration closes at noon on the day of the call or when available space has been filled.
CMS has just announced that it is holding a public meeting on July 16, 2015 to discuss Medicare clinical laboratory fee schedule (CLFS) payment for new or substantially revised HCPCS codes for calendar year 2016. At the meeting, the public also will have an opportunity to comment on certain reconsideration requests regarding test code payment determinations made last year. Presenters must register and submit presentations to CMS by July 2, 2015. CMS intends to publish its proposed determinations for new test codes and preliminary determinations for reconsidered codes for CY 2016 by early September 2015; a public comment period will follow. Final determinations for new test codes to be included for payment on the CLFS for CY 2016 and reconsidered codes will be released in November 2015.
On May 7, 2015, CMS is hosting a Special Open Door Forum to discuss its plans to use Home Health CAHPS survey results to create Patient Survey Star Ratings for the Home Health Compare website. CMS will provide an overview of the HHCAHPS Patient Survey Star Ratings, describe the methods for calculating the ratings and assigning stars, and take questions.
On May 20, 2015, CMS is hosting its final call to discuss paper and clinical templates intended to assist physicians and practitioners in documenting patient eligibility for Medicare home health benefits.
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 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.
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.
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.
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.
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 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.
Update: All preliminary decisions are now posted..
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.