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CMS Seeks Ways to Enhance Provider Experience with MACs

CMS is hosting three listening sessions in January 2020 on how to “improve processes and enhance interactions” between the Medicare Administrative Contractors (MACs) and providers and suppliers, particularly with regard to operations, technology, and business functions.  CMS also seeks ideas for ways to enhance beneficiary quality of care and the beneficiary customer service experience with … Continue Reading

Speakers from WebMD, CMS, PhRMA, AdvaMed, AHCA, and More to Present at Reed Smith’s Dec. 4 Washington Health Care Conference

Reed Smith is hosting its 6th Annual Washington Health Care Conference on December 4, 2019 at The Almas Center in Washington, D.C., and is pleased to welcome another impressive line-up of speakers this year. Our keynote speaker is Dr. John Whyte, Chief Medical Officer of WebMD, who will be discussing “Artificial Intelligence in Health Care: … Continue Reading

CMS Schedules Town Hall Meeting to Consider FY 2021 IPPS New Technology Add-On Payment Applications

Fiscal year (FY) 2021 applications for Medicare inpatient prospective payment system (IPPS) new technology add-on payments will be discussed at a December 16, 2019 Centers for Medicare & Medicaid Services (CMS) town hall meeting.  Depending on the number of applications, a second day of meetings may be held on December 17.  The meetings provide an … Continue Reading

CMS Plans June 27 “Listening Session” on Draft Hospital Co-Location Guidance

CMS has scheduled a June 27, 2019 listening session to get public feedback on its recent draft guidance on how state surveyors should evaluate hospital co-location arrangements for compliance with the Medicare hospital conditions of participation (COPs).  In particular, CMS is looking for input on how the guidance addresses staffing, contracted services, emergency services, and distinct … Continue Reading

Medicare OPPS Advisory Panel to Meet August 19-20, 2019

The annual Advisory Panel on Hospital Outpatient Payment meeting will be held on August 19-20, 2019, the Centers for Medicare & Medicaid Services (CMS) has announced.  The Panel is charged with advising CMS on outpatient prospective payment system (OPPS) ambulatory payment classification clinical integrity and weights, along with hospital outpatient therapeutic services supervision issues.  The deadline for … Continue Reading

CMS Announces Plans to Kick Off 2020 Medicare Clinical Lab Test Update Process

The Centers for Medicare & Medicaid Services (CMS) has scheduled a June 24, 2019 public meeting on calendar year (CY) 2020 Medicare Clinical Laboratory Fee Schedule (CLFS) payments for new or substantially revised clinical lab codes.  Specifically, the June meeting will provide an opportunity for the public to submit comments on the appropriate basis — … Continue Reading

CMS Sets Schedule for Public Meetings on 2020 HCPCS Code Applications

CMS has announced the schedule for public meetings on pending applications for new or revised HCPCS codes for calendar year 2020: May 13-15, 2019 — Drugs/Biologicals/ Radiopharmaceuticals/Radiologic Imaging Agents. June 11-12, 2019 — Durable Medical Equipment and Accessories, Orthotics and Prosthetics and Supplies, and Other CMS intends to release the agenda and preliminary coding determinations … Continue Reading

CMS Educational Event on New Part D Opioid Overutilization Policies

On February 14, 2019, CMS is hosting an educational call on new opioid policies for Medicare drug plans.  The call will focus on improved safety alerts when opioid prescriptions are dispensed at the pharmacy, and drug management programs for individuals at-risk for misusing or abusing “frequently abused drugs” (opioids and benzodiazepines).  The target audience for … Continue Reading

CMS Call on Clinical Diagnostic Laboratory Reporting of Private Payor Rates

On January 22, 2019, CMS is hosting a “refresher call” on Medicare requirements for certain clinical laboratories to report private payor rates and volume data for clinical diagnostic laboratory tests paid under the Clinical Laboratory Fee Schedule (CLFS).  Data collected during the period of January 1, 2019 and June 30, 2019 will be used to … Continue Reading

CMS to Host Call on Changes to HCPCS Coding Policies

CMS is hosting a Special Open Door Forum on December 18, 2018 to discuss changes to Healthcare Common Procedure Coding System (HCPCS) policies for the 2019-2020 coding cycle.  As previously reported, CMS expects the changes to increase transparency in the HCPCS coding process.  The Special Open Door Forum will provide stakeholders with an opportunity to … Continue Reading

FY 2020 IPPS New Technology Add-On Payment Applications to be Weighed at December 4, 2018 CMS Town Hall Meeting

The Centers for Medicare & Medicaid Services (CMS) is holding a Town Hall Meeting on December 4, 2018 to discuss fiscal year (FY) 2020 applications for add-on payments for new medical services and technologies under the Medicare inpatient prospective payment system (IPPS).  Interested parties will have an opportunity to present recommendations and data regarding whether … Continue Reading

CMS Schedules Provider Compliance Focus Group Meeting (Oct. 5)

CMS is hosting an October 5, 2018 “Provider Compliance Focus Group” meeting to address several Medicare fee-for-service compliance topics, including the Recovery Audit Contractor (RAC) and targeted probe and educate programs.  The intended audience for the meeting is physicians, non-physician practitioners, billing specialists, suppliers, and associations.  Registration is required; attendees can choose to participate by … Continue Reading

CMS Educational Call on Proposed CY 2019 Physician Fee Schedule Rule (Aug. 22)

CMS is inviting stakeholders to participate an August 22, 2019 listening session on the CY 2019 proposed Medicare physician fee schedule rule.  The call will focus on three aspects of the proposed rule: Streamlining Evaluation and Management (E/M) payment policies Advancing virtual care Changes to the Quality Payment Program intended to reduce clinician burden, focus … Continue Reading

CMS Hosts Forum for Opioid Prescribers to Address the Opioid Epidemic (Aug. 15)

On August 15, 2018, CMS is convening a Special Open Door Forum on “Sharing Federal Strategies to Address the Opioid Epidemic.”  The conference call, which will feature representatives from several Department of Health and Human Services agencies, is intended to educate opioid prescribers on federal resources and strategies for safe prescribing as well as other … Continue Reading

CMS Schedules July 13 Focus Group Meeting on Provider Compliance Issues

Citing an interest in improving its processes and eliminating unnecessary requirements, CMS is hosting July 13, 2018 “Provider Compliance Focus Group” meeting regarding Medicare fee-for-service compliance topics, including medical review, targeted probe and educate, and Recovery Audit Contractors.  CMS states that it wants “to ensure claims are paid appropriately and preserve the Medicare Trust Fund … Continue Reading

Medicare OPPS Advisory Panel to Hold Annual Meeting August 20-21, 2018

CMS is holding its annual Advisory Panel on Hospital Outpatient Payment meeting on August 20-21 2018.  The Panel advises CMS on ambulatory payment classification clinical integrity and weights, along with hospital outpatient therapeutic services supervision issues.  The deadline for presentations and comments is July 23, and registration runs through July 30.… Continue Reading

Public Meetings to Address 2019 Medicare Clinical Lab Tests and Payment

On June 25, 2018, CMS is holding its annual public meeting to consider the appropriate basis (crosswalking or gapfilling) for establishing payment amounts for new or substantially revised HCPCS codes being considered for payment under the 2019 Medicare clinical laboratory fee schedule (CLFS). The meeting will also address reconsideration requests regarding final determinations made last … Continue Reading

CMS to Educate Drug Manufacturers on Navigating New ASP Reporting System

CMS is requiring prescription drug manufacturers that report average sales price (ASP) data to use a new automated system, beginning with the second quarter 2018 ASP data submission (due April 30, 2018).  To help manufacturers navigate the new system, CMS is hosting a March 27, 2018 educational call, which will include a question and answer … Continue Reading

CMS Announces Schedule for Public Meetings on Pending HCPCS Applications

CMS has set the dates for its annual meetings to discuss applications for new and revised HCPCS codes: May 14-17, 2018: Drugs, Biologicals, Radiopharmaceuticals, Radiologic Imaging Agents June 5-6, 2018: Durable Medical Equipment and Accessories, Orthotics and Prosthetics, Supplies, Other [note that the Federal Register includes two sets of dates for this session; we have confirmed that … Continue Reading

CMS Wants Physicians to Speak Up on Reducing E/M Services Documentation Burden (March 21)

CMS is hosting a call on March 21, 2018 to get feedback from physicians and non-physician practitioners on Evaluation and Management (E/M) services. According to the CMS announcement, the agency is looking for information from stakeholders on how the E/M guidelines can be updated “to reduce burden and better align coding and documentation with the … Continue Reading

CMS Plans Q&A Session on Low Volume Appeals Settlement Option (Feb. 13)

As previously reported, CMS has initiated a “low volume appeals (LVA) settlement” option as part of broader HHS efforts to improve the Medicare appeals process. This option is available for appellants with fewer than 500 total Medicare Part A or Part B claim appeals pending at the Office of Medicare Hearings and Appeals and the … Continue Reading

Trump Administration Unveils Its First Bundled Payment Initiative — BPCI Advanced

The Trump Administration has rolled out its first CMS Innovation Center Medicare bundled payment initiative, the Bundled Payments for Care Improvement Advanced (BPCI Advanced). Under the new voluntary model, CMS will test whether bundled payments for 29 inpatient and 3 outpatient clinical episodes will lead to reduced Medicare expenditures while improving quality of care for … Continue Reading