Tag Archives: Physician Quality

CMS Finalizes Medicare Physician Fee Schedule Update for 2018

Delays AUC Requirement until 2020, Cuts Off-Campus Hospital Department Payments The Centers for Medicare & Medicaid Services (CMS) has published its final Medicare physician fee schedule (PFS) rule for CY 2018. In addition to updating rates for 2018, the rule includes important policy changes, including an additional delay in implementation of appropriate use criteria (AUC) … 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

Energy & Commerce Committee Hearing to Focus on Physician Preparation for MACRA Reforms (April 19)

On April 19, 2016, the House Energy and Commerce Subcommittee on Health is holding a hearing entitled “Medicare Access and CHIP Reauthorization Act of 2015: Examining Physician Efforts to Prepare for Medicare Payment Reforms.”  The hearing will focus on major physician organizations’ investments in the development of alternative payment models, quality measures, and practice improvements.… Continue Reading

CMS, AHIP Release Multi-Payer Physician Quality Measure Sets

CMS and America’s Health Insurance Plans (AHIP) recently released seven sets of physician clinical quality measures as part of a “Core Quality Measures Collaborative” intended to align quality measures among payers and reduce the reporting burden on providers. Through the Collaborative, CMS, various commercial plans, Medicare and Medicaid managed care plans, purchasers, and provider and … Continue Reading

CMS Call: 2016 Medicare Physician Quality Reporting Programs (Dec. 8)

On December 8, 2015, CMS is hosting a call to discuss how the 2016 Medicare Physician Fee Schedule final rule impacts Medicare quality reporting programs.  Specifically, the call will address changes to the Physician Quality Reporting System, the Electronic Health Record Incentive Program, the Comprehensive Primary Care initiative, the Value-Based Payment Modifier, the Medicare Shared … Continue Reading

CMS Announces Efforts to Ease ICD-10 Transition

Today CMS announced steps to help physicians prepare for the switch to ICD-10 coding on October 1, 2015.  Most significantly, CMS announced that during the first year after ICD-10 implementation, Medicare contractors will not deny physician or other practitioner Part B physician fee schedule claims based solely on the specificity of the ICD-10 diagnosis code, … Continue Reading

HHS Sets Ambitious Goals for Medicare Quality/Value-Based Purchasing, Alternative Payment Models

Today HHS Secretary Sylvia M. Burwell announced ambitious plans to move from “volume to value in Medicare payments” by accelerating the share of Medicare fee-for-service (FFS) payments that are tied to quality and value and reimbursed through alternative payment models. The first goal in the initiative is for 30% of Medicare provider payments to be in … Continue Reading

Bipartisan/Bicameral SGR Reform Bill Released; Offsets Not Yet Identified

The bipartisan leadership of the House Energy and Commerce Committee, House Ways & Means Committee, and Senate Finance Committee have released a consensus Medicare physician fee schedule reform bill expected to be considered by Congress before the latest temporary payment patch expires at the end of March. Highlights of H.R. 4015, the SGR Repeal and Medicare … Continue Reading

CMS to Host “Physician Compare Town Hall Meeting” (Feb. 24)

On February 24, 2014, CMS is hosting a town hall meeting to discuss the future of the Physician Compare website and how to improve the information presented to consumers. For instance, CMS is seeking feedback on additional measures that might help consumers identify quality care, and measures to accurately and completely represent the various Medicare … Continue Reading

Updated House SGR Reform Proposal

The chairmen of the House Energy and Commerce Committee and Ways and Means Committee have provided additional details regarding their proposal to repeal the current Medicare physician fee schedule sustainable growth rate (SGR) methodology and replace it with an alternative physician payment system. The update builds on comments received from the public on the panels’ February … Continue Reading

House Panels Invite Comments on Medicare SGR/Physician Fee Schedule Reform

The Chairmen of the House Ways and Means Committee and House Energy and Commerce Committee are inviting comments on the outline of a proposal to permanently repeal the sustainable growth rate (SGR) formula for updating Medicare physician fee schedule payments and institute other payment reforms. The lawmakers are considering a three-phase proposal. In the first … Continue Reading

ACA Medicare Data Sharing Provision Implementation Proceeds

On November 21, 2012, CMS announced that it is entering into contracts with three organizations to implement the ACA’s Medicare Data Sharing for Performance Measurement provision. The provision requires CMS to make available to “qualified entities” standardized extracts of Medicare claims data under Parts A, B, and D for purposes of evaluating provider and supplier … Continue Reading

CMS Proposes Update to 2013 Medicare Physician Rates, Other Part B Policies

On July 30, 2012, CMS is publishing a proposed rule updating the Medicare physician fee schedule (MPFS) for 2013 and modifying numerous other Medicare Part B policies. Most significantly, the proposed rule would impose a 27% across-the-board cut in MPFS payments, largely due to the statutory Sustainable Growth Rate (SGR) update formula (although Congress is … Continue Reading

CMS Seeks Early Input on Future Quality & Efficiency Measures

CMS has made available a list of quality and efficiency measures being considered for adoption in 2012 under the ACA’s pre-rulemaking process for such measures. CMS lists 366 measures under consideration – more than one-third of which would be used in the Physician Quality Reporting System, while others would be used for a variety of other … Continue Reading

CMS Call: Payment Standardization and Risk Adjustment for the Medicare Physician Feedback & Value Modifier Programs (Dec. 21)

On December 21, 2011, CMS is hosting a call on per capita cost measures under two Medicare physician policies: (1) the Physician Feedback Program (under which CMS provides confidential feedback reports to physicians and group practices about the resource use and quality of care provided to Medicare patients), and (2) the ACA requirement that CMS … Continue Reading

CMS Issues Final Medicare Physician Fee Schedule Rule for 2012

Medicare physician fee schedule (MPFS) payments are scheduled to be cut by 27.4% in 2012 under the Centers for Medicare & Medicaid Services’ (CMS) final rule to be published November 28, 2011. The steep reduction is a result of the statutory Sustainable Growth Rate (SGR) formula. While Congress is widely expected to take action to mitigate the … Continue Reading

GAO Assesses Challenges with CMS Physician Feedback Program

The Government Accountability Office (GAO) has issued a report entitled “CMS Faces Challenges with Methodology and Distribution of Physician Reports.” By way of background, CMS has established the Physician Feedback Program to give physicians confidential feedback on the resources used to provide care to Medicare beneficiaries, as mandated by the Medicare Improvements for Patients and Providers … Continue Reading