Tag Archives: Merit-based Incentive Payment System (MIPS)

CMS Proposes Changes to for Second Year of Medicare Physician Quality Payment Program

CMS has proposed new regulations to continue implementing the “Quality Payment Program” (QPP) — the new Medicare physician fee schedule (MPFS) update framework mandated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). As previously reported, starting in 2017, physicians will be paid under the Merit-based Incentive Payment System (MIPS) or the Advanced … 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 Finalizes Two-Track System to Implement MACRA Medicare Physician Payment Policy Changes

Temporary Transition Policies Reduce Threat of Negative Adjustments in 2019, But Adds to Complexity On November 4, 2016, the Centers for Medicare & Medicaid Services (CMS) is publishing a sweeping final rule reforming the Medicare physician fee schedule (MPFS) update framework, as mandated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).  Beginning … Continue Reading

CMS Announces Flexibility for Physician First-Year Participation in MACRA Quality Payment Program

In a recent blog post, CMS Acting Administrator Andy Slavitt announced CMS’s plans to give physicians more options for complying with significant upcoming changes to Medicare physician fee schedule (MPFS) rules – which will help physicians avoid triggering a negative payment adjustment in the first year of the program. As previously reported, the Medicare Access … Continue Reading

CMS Proposes Implementation of MACRA Physician Payment Reforms

The Centers for Medicare & Medicaid Services (CMS) has proposed regulations to implement major reforms of the Medicare physician fee schedule (MPFS) update framework that were mandated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).  As discussed in our client alert, MACRA repealed the longstanding sustainable growth rate (SGR) methodology for updating … Continue Reading

CMS Moving Ahead on Medicare Physician Payment Reform; Proposed MACRA Rule at OMB

The White House Office of Management and Budget (OMB) is now reviewing a highly-anticipated Centers for Medicare & Medicaid Services’ (CMS) proposed rule to implement major Medicare physician payment reform provisions included in the Medicare Access and CHIP Reauthorization Act (MACRA).  As previously reported, MACRA repealed the Medicare sustainable growth rate (SGR) formula and directed … Continue Reading

CMS Seeks Comments on Draft Physician Fee Schedule Quality Measure Development Plan

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires CMS to develop quality measures that will apply to Medicare payments to physicians when new Merit-based Incentive Payment System (MIPS) and Medicare alternative payment model (APM) provisions go into effect (MIPS and APM payment adjustments begin in 2019).  Pursuant to this mandate, CMS has … Continue Reading

CMS Invites Comments on MACRA Episode Groups

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires CMS to establish care episode groups and patient condition groups, which will be used to measure resource use under the new Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). Care episode groups describe the patient’s clinical problems at the time items and … Continue Reading

CMS Adopts Changes to Medicare & Medicaid EHR Policies

The Centers for Medicare & Medicaid Services (CMS) has published a sweeping final rule with comment period that specifies the requirements that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to qualify for Medicare and Medicaid electronic health record (EHR) incentive payments and avoid downward payment adjustments under the … Continue Reading

CMS Provides More Time to Comment on MACRA Physician Payment Reforms

CMS has extended the comment period on its October 1, 2015 request for information (RFI) regarding implementation of the Merit-based Incentive Payment System and promotion of alternative payment models in accordance with MACRA. The comment period, which originally was scheduled to end on November 2, 2015, has been extended until November 17, 2015. CMS also … Continue Reading

MedPAC Meeting on Medicare Policies (Oct. 8-9)

The next Medicare Payment Advisory Commission (MedPAC) meeting is scheduled for October 8 -9, 2015. Topics on the agenda include: Medicare drug spending; Alternative Payment Models and the Merit-based Incentive Payment System; Medicare Advantage coding intensity, health risk assessments, benchmarks, and star ratings; and access to emergency care in rural areas.… Continue Reading

CMS Seeks Input on MACRA Physician Payment Reform Implementation

On October 1, 2015, CMS published a request for information (RFI) regarding implementation of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) provisions that mandate significant reforms of the Medicare physician payment system. As previously reported, MACRA repealed the sustainable growth rate methodology (SGR) for updating the Medicare physician fee schedule, and after a … Continue Reading

Proposed CY 2016 MPFS Rule Takes First Steps in Implementing MACRA Reforms

On July 15, 2015, the Centers for Medicare & Medicaid Services (CMS) published its proposed rule to update the Medicare physician fee schedule (MPFS) for CY 2016 – the first rulemaking since the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repealed the sustainable growth rate (SGR) formula.  Under the proposed rule, the 2016 … Continue Reading

President Obama Signs MACRA: Permanently Reforms Medicare Physician Reimbursement Framework, Includes Other Health Policy Provisions

Today President Obama signed into law H.R. 2, the "Medicare Access and CHIP Reauthorization Act of 2015" (MACRA), which reforms Medicare payment policy for physician services and adopts a series of policy changes affecting a wide range of providers and suppliers. Most notably, MACRA permanently repeals the statutory Sustainable Growth Rate (SGR) formula, achieving a goal that has eluded Congress for years. Now, after a period of stable payment updates, MACRA will link physician payment updates to quality, value measurements, and participation in alternative payment models.… Continue Reading
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