Tag Archives: Healthcare Reform

MIPS Reporting: Getting Off on the Right Foot

A physician who did not report performance on quality measures to the Physician Quality Reporting System (PQRS) for 2015 now faces a 6% penalty on all Medicare Part B payments.  The same penalty will apply in 2018 for physicians who do not report performance for 2016. In addition to PQRS penalties, a 3% penalty now … Continue Reading

Clock Ticking on New Revenue Opportunity for MSSP ACOs

On December 8, the Center for Medicare and Medicaid Innovation (CMMI) announced two new models to increase patient engagement in care decisions by putting more information in the hands of Medicare beneficiaries. Under one of these models, the Shared Decision Making (SDM) Model, CMMI will pay ACOs participating in the Medicare Shared Savings Program or the … Continue Reading

May 31 Deadline for 2017 Medicare Shared Savings Program

An organization interested in participating in the Medicare Shared Savings Program (MSSP) as an accountable care organization (ACO) must file a non-binding notice of intent (NOI) by 5:00 pm EDT Tuesday, May 31.  Only those organizations that file an NOI will be permitted to file an MSSP application, which will be due by 5:00 pm … Continue Reading

MIPS Proposed Rule: Big Changes to Medicare Physician Payments Starting in 2017

Good news:  2016 is the last year physicians have to report performance measure scores to the Centers for Medicare & Medicaid Services (CMS) to avoid up to a 9% reduction in Medicare Physician Fee Schedule (MPFS) payments under the Physician Quality Reporting System (PQRS), the Value-Based Modifier Program, and the Meaningful Use Program. Not-so-good-news:  A … Continue Reading

Top 10 Provisions in the 2016 Medicare Physician Fee Schedule Final Rule

On October 30, 2015, the Centers for Medicare & Medicaid Services (CMS) released the 2016 Medicare Physician Fee Schedule Final Rule (Final Rule). Weighing in at 1,358 pages, the Final Rule covers a wide range of subjects, including payment methodologies, advance care planning, and physician value-based purchasing programs. The Final Rule will be published in the Federal Register November 16.… Continue Reading

CMS Fine Tunes Value Modifier as MIPS Prepares to Take the Stage

Since the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) became law in April, all talk has been about the new Merit-Based Incentive Payment System (MIPS), which will replace the current Physician Value Modifier Program (VM Program) in 2019. For the next 3 years, however, the VM Program will determine provider payments.… Continue Reading

Mandatory Medicare Bundled Payments: Comprehensive Care for Joint Replacement

The Centers for Medicare & Medicaid Services (CMS) proposes to convert one of the voluntary programs--Bundled Payment for Care Improvement (BPCI)--into a regulatory mandate. Despite the limited evaluative data now available, CMS believes bundled payments hold great promise to improve quality and coordination of care through an entire episode of care.… Continue Reading