Health Care Industry Events

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

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

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 Medicare beneficiaries. CMS anticipates that the performance period of the BPCI Advanced model will begin on October 1, 2018 and run through December 31, 2023.

BPCI Advanced builds on the ongoing Bundled Payments for Care Improvement (BPCI) initiative, which was launched in 2013 and runs through September 30, 2018. As in the BPCI model, BPCI Advanced seeks to incentivize providers to coordinate care to furnish services more efficiently while maintaining quality. Specifically, participants may either realize a gain or loss depending both on (1) how successfully they manage total Medicare fee-for-service costs of care (with limited exceptions) throughout each 90-day episode of care and (2) performance on specified quality measures.

There are key differences between the original BPCI and BPCI Advanced models, including the following (among others):
Continue Reading Trump Administration Unveils Its First Bundled Payment Initiative — BPCI Advanced

CMS is hosting a call on January 23, 2018 to brief state Medicaid agencies, Medicaid providers, managed care organizations, and other Medicaid stakeholders about the new Medicare card project. Under this initiative, CMS is moving away from Social Security Number-based Health Insurance Claim Numbers to new Medicare Beneficiary Identifiers (MBIs).

1/22 update:  this call

On January 9, 2018, CMS is hosting a call to discuss its new low volume appeals settlement option. As previously reported, this option is available for certain Medicare fee-for-service providers, physicians, and other suppliers with fewer than 500 appeals pending at the Office of Medicare Hearings and Appeals and the Medicare Appeals Council at

The Energy and Commerce Subcommittee on Health has scheduled an October 11, 2017 hearing to discuss how covered entities use the 340B drug pricing program. A second Subcommittee hearing on October 11 will consider proposals from House members on ways to address the opioid crisis.

On October 17, the Senate Health, Education, Labor, and Pensions

The Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests (CDLTs) is holding a public meeting on Monday, September 25, 2017.  The Panel will discuss calendar year 2018 clinical laboratory fee schedule codes for which CMS received no applicable information to calculate a Medicare payment rate.  The list of CDLTs that will be discussed during

The CMS Center for Medicare and Medicaid Innovation is holding a public summit on September 8, 2017 to explore creating a behavioral health innovative payment model intended to improve health care quality and access, while lowering the cost of care for Medicare, Medicaid, or Children’s Health Insurance Program (CHIP) beneficiaries with behavioral health conditions. The

On June 20, 2017, CMS is hosting a Special Open Door Forum conference call to discuss implementation of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). According to a CMS announcement, the call will cover the goals of the IMPACT Act, RAND contract activities (including upcoming national testing), and identify opportunities

CMS is holding a call on June 29, 2017 to discuss recent regulatory changes intended to streamline the Medicare administrative appeal processes, reduce the backlog of pending appeals, and increase consistency in decision-making across appeal levels. The call will also cover how certain appeals pending at the Office of Medicare Hearings and Appeals “may be

CMS is holding its annual Advisory Panel on Hospital Outpatient Payment meeting on August 21-22 2017.  The purpose of the Panel is to advise HHS and CMS on ambulatory payment classification (APC) clinical integrity and weights and hospital outpatient therapeutic services supervision issues.  Topics that may be considered during the meeting include:

  • Whether procedures