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Cuts to Medicare DMEPOS Payment Based on Competitive Bidding Prices – Opportunity to Comment

CMS is seeking input from stakeholders on how it should use data from the durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) competitive bidding program to adjust (cut) Medicare DMEPOS fee schedule amounts outside of bidding areas (CBAs), as required by the 21st Century Cures Act. The Cures Act mandates that CMS take such stakeholder … Continue Reading

2018 “Next Generation” Accountable Care Organization (ACO) Models

CMS is soliciting applications for 2018 Next Generation ACOs, an Innovation Center initiative intended to promote Medicare quality improvement and care coordination. Letters of intent are due May 4, 2017. CMS is holding a series of calls to discuss the model and the application process, including the following: March 14, 2017: Application Overview and Participating … Continue Reading

CMS Schedules 2017 Meetings to Consider HCPCS Code Applications

CMS has just announced the dates for its annual meetings to discuss pending applications for new and revised HCPCS codes: May 16 – 18, 2017: Drugs/Biologicals/Radiopharmaceuticals/Radiologic Imaging Agents June 7 – 8, 2017: Durable Medical Equipment and Accessories/Orthotics and Prosthetics/Supplies/Other Deadlines and instructions for speaker and general registration and submission of comments are set forth … Continue Reading

ICD-10 Coordination and Maintenance Committee Meeting Scheduled for March 7-8, 2017

The ICD-10 Coordination and Maintenance Committee is meeting on March 7 and 8, 2017, to discuss proposed code changes to ICD-10-CM and ICD-10-PCS. The March 7, 2017 session will focus on procedure codes, and the March 8 meeting will address diagnosis codes.  The registration deadline to attend the meetings is February 25, 2017.… Continue Reading

CMS Call on Required Data Reporting for Global Surgery/Post-Operative Care (April 25)

CMS has scheduled an April 25, 2017 call to discuss new data reporting requirements for clinicians in selected states who furnish global surgery services, as authorized by the Medicare Access and CHIP Reauthorization Act (MACRA). Specifically, the 2017 Medicare physician fee schedule (MPFS) final rule established a data reporting requirement for practitioners furnishing specified global … Continue Reading

CMS to Host Call on Transitioning Physician Quality Reporting to MIPS (Jan. 24)

On January 24, 2017, CMS is hosting a call to discuss how to complete the final reporting period for the “legacy” Medicare physician quality reporting programs (Physician Quality Reporting System, Medicare Electronic Health Record Incentive Program, and Value-Based Payment Modifier) and transition to the new Merit-based Incentive Payment System (MIPS).  Registration is required to participate.… Continue Reading

CMS to Host Calls on Hospital Appeals Settlement Process (Nov. 16 & Dec. 12)

On November 16, 2016, CMS is hosting a call to provide an update on its latest plans to allow eligible providers to settle their inpatient status claims currently under appeal using the Hospital Appeals Settlement process. By way of background, this administrative settlement process will be available beginning December 1, 2016 for eligible hospitals that … Continue Reading

CMS Plans “Listening Session” on Part D Drug Management Programs under CARA (Nov. 14)

CMS is hosting a November 14, 2016 “listening session” to obtain stakeholder input on implementation of section 704 of the Comprehensive Addiction and Recovery Act of 2016 (CARA), Under this provision, Medicare Part D sponsors may establish drug management programs for at-risk beneficiaries to limit access to frequently-abused drugs to certain prescribers and pharmacies. Topics … Continue Reading

CMS to Host November 2 Call on Clinical Diagnostic Lab Test Payment System Data Reporting

CMS is hosting an educational call on November 2, 2016 to discuss reporting obligations under the June 23, 2016 Clinical Diagnostic Test Payment System final rule.  As previously reported, under the Protecting Access to Medicare Act (PAMA), certain laboratories must report data to CMS on private payor rates and volume of clinical laboratory tests, which … Continue Reading

Upcoming FDA Public Meeting on Speech and Medical Products

As a reminder, the Food and Drug Administration (FDA) is holding a two-day public meeting on November 9 and 10, 2016 regarding “Manufacturer Communications Regarding Unapproved Uses of Approved or Cleared Medical Products.”  The meeting comes at a time where recent litigation has raised hot-button issues regarding the relationship between FDA, off-label use of drugs … Continue Reading

CMS Call: How to Report Across 2016 Medicare Quality Programs (November 1)

CMS is hosting a call on November 1, 2016 to discuss how physicians and other providers can report quality measures during 2016 to maximize participation in Medicare quality programs, including the Physician Quality Reporting System (PQRS), Medicare Electronic Health Record (EHR) Incentive Program, Value-Based Payment Modifier (Value Modifier), and the Medicare Shared Savings Program.… Continue Reading

CMS Call on New Medicare/Medicaid Emergency Preparedness Requirements (Oct. 5)

On October 5, 2016, CMS is hosting a call to discuss its September 16, 2016 final rule establishing emergency preparedness requirements for Medicare- and Medicaid-participating providers and suppliers to ensure that they can meet the needs of patients and residents during natural and man-made emergency situations. The call will discuss provisions of the final rule, … Continue Reading

CMS IMPACT Act Educational Calls – Focus on Care Coordination (Sept.15) and Data Elements (Oct. 13)

CMS has scheduled a September 15, 2016 Special Open Door Forum call on the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). This call will provide an overview of the IMPACT Act’s requirement for standardization of patient assessment data across post-acute care settings, and solicit input on the ways the IMPACT Act can help improve … Continue Reading

FDA to Host Public Hearing on Manufacturer Communications Regarding Unapproved Uses of Medical Products

On November 9 and 10, 2016, the Food and Drug Administration (FDA) is hosting a public hearing on “Manufacturer Communications Regarding Unapproved Uses of Approved or Cleared Medical Products.” The hearing is intended to inform FDA’s “comprehensive review of its regulations and policies” pertaining to such communications. The FDA poses a number of specific questions … Continue Reading

CMS Schedules Next Meeting of Advisory Panel on Clinical Diagnostic Laboratory Tests for September 12

CMS has announced that the next meeting date of the Advisory Panel on Clinical Diagnostic Laboratory Tests will be September 12, 2016.  The meeting is expected to cover: Payment options for routine chemistry tests that are currently paid as Automated Test Panels (ATPs) under the new payment system for clinical diagnostic laboratory tests effective January … Continue Reading

MACRA Physician-Focused Payment Model Technical Advisory Committee to Meet September 16

The Physician-Focused Payment Model Technical Advisory Committee will meet on September 16, 2016.  The Committee will continue discussions about the process by which physician focused payment model proposals will be received and reviewed by the Committee in accordance with regulations implementing Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) physician payment reforms. … Continue Reading

CMS Selects Regions for Primary Care Innovation Model

CMS has opened the application period for physician practices interested in participating in its new primary care model, Comprehensive Primary Care Plus (CPC+), which is intended to improve how primary care is delivered and reimbursed. CMS also announced that the following 14 regions have been selected to participate in CPC+ (statewide unless otherwise noted): Arkansas; … Continue Reading

CMS Hosts Call on Potential Future Changes to Open Payments/Sunshine Act Reporting Requirements (Aug. 2)

On August 2, 2016, CMS is hosting a Special Open Door Forum Call on potential future changes to Open Payments/Physician Payments Sunshine Act requirements for reporting payments and transfers of value made by drug and device manufacturers and group purchasing organization (GPOs) to physicians and teaching hospitals, as well as physician ownership information. … Continue Reading
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