Tag Archives: Medicare

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

CMS Announces New Alternative Payment Model for Primary Care Providers

Back in 2012, the Center for Medicare and Medicaid Innovation (CMMI) launched the Comprehensive Primary Care Initiative (CPCI), joining with 38 payers to support 500 practices across 7 regions in transforming primary care.  With CPCI scheduled to end later this year,  CMMI announced (April 11) the launch of its largest investment in advanced primary care … 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

Companion Infographic to PYA CCM White Paper

Starting this month, physicians can bill on a monthly basis for providing chronic care management (CCM) services to Medicare beneficiaries with two or more chronic conditions. PYA's white paper, Providing and Billing Medicare for Chronic Care Management - 2015 Medicare Physician Fee Schedule Final Rule, details the requirements for this new service.… Continue Reading

MedPAC Recommendations: New Approach to Quality Measurement, Per-Beneficiary Payments for Primary Care

The Medicare Payment Advisory Commission (MedPAC) is an independent congressional agency established by the Balanced Budget Act of 1997 to advise Congress on issues affecting the Medicare program. Its 17 Commissioners meet publicly to discuss policy issues and formulate recommendations based on staff research, presentations by policy experts, and comments from interested parties.… Continue Reading