The Centers for Medicare & Medicaid Services (CMS) announced more new opportunities for clinicians to join Advanced Alternative Payment Models (APMs) to improve care and earn additional incentive payments under the Quality Payment Program, which implements the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as a payment alternative to the Sustainable Growth Rate (SGR). Beginning in… Read More
The United States Senate Committee on Finance released a report this week on the practice of concurrent and overlapping surgeries. According to the committee’s news release, the report “outlines a number of shortfalls at the federal level in monitoring and auditing teaching hospitals to ensure they are in compliance with Medicare billing restrictions, while also making a number… Read More
In a letter to CMS Acting Administrator, Andrew M. Slavitt, AAHKS joined other medical societies in recommending that CMS restores the Refinement Panel to serve as the relative value appeals process that was appropriately in place prior to 2011. CMS had convened the Refinement Panel to review public comments, hear testimony from practicing physicians and independently recommend refinements… Read More
AAHKS leadership are heading to Baltimore and Washington, DC, to meet with officials from the CMS Center for Medicare & Medicaid Innovation (CMMI) and Members of Congress. Discussion will revolve around Advanced Alternate Payment Model (APM) requirements, and how more AAHKS members can become eligible for receiving payment enhancements.
CMS intends to implement a new voluntary bundled payment model for CY 2018, based upon BPCI, where the model(s) would be designed to meet the criteria to be an Advanced APM. The BPCI initiative Models 2, 3, and 4 would not currently qualify as Advanced APMs based on the two of the Advanced APM criteria: payment based on… Read More
The Centers for Medicare & Medicaid Services (CMS) is hosting the Quality Payment Program National Stakeholder Call on Monday, August 1, 2016, from 2:00 p.m. – 3:00 p.m. ET. The number to call is 1-800-837-1935, and conference ID is 43116806. TTY Communications Relay Services are available for the hearing or speech- impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications… Read More
The United States Department of Defense issued a notice that they have started a test bundled payment process called “TRICARE Bundled Payment for Lower Extremity Joint Replacement or Reattachment” (LEJR). According to the statement, TRICARE will be based on the CJR Model and will take place in the Military Health System in the Tampa-St. Petersburg area for DRG… Read More
Epstein Becker & Green reviewed the March Medicare Payment Advisory Commission (MedPAC) Report and prepared the following summary of issues AAHKS is tracking: MedPAC’s March Report includes analyses of payment adequacy in fee-for-service Medicare and makes recommendations for 2017 rate adjustments under the various fee-for-service payment systems. The report also provides a review of Medicare Advantage and the… Read More