Centers for Medicare & Medicaid Services

MedPAC Comments on Proposed Physician Fee Schedule

The Medicare Payment Advisory Commission has written to the Centers for Medicare & Medicaid Services to convey its views on CMS’s proposed revisions to Medicare physician payment policies for 2018. Among the issues MedPAC addresses in its comment letter are proposed payments to physicians for nonexcepted items and services provided in nonexcepted off-campus provider-based hospital departments, the Medicare shared savings program, and the Medicare diabetes prevention program. See CMS’s comment letter here.

iqtsupport2017-09-12T06:00:52-04:00September 12, 2017|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations, MedPAC|

MedPAC Comments on Proposed Medicare Outpatient Payment Rule

The Medicare Payment Advisory Commission has weighed in with the Centers for Medicare & Medicaid Services on its proposed regulation governing the 2018 hospital outpatient prospective payment system and ambulatory surgical center payment systems and quality reporting programs. Among the issues MedPAC addresses in its comment letter to CMS are the proposal to reduce Medicare reimbursement for 340B-covered prescription drugs; how to reinvest the savings such a payment cut would produce; the ability of hospitals to expand the services they offer at hospital-based outpatient departments; proposed changes in the Medicare hospital outpatient quality reporting program and ambulatory surgery center quality [...]

iqtsupport2017-09-11T09:59:57-04:00September 11, 2017|Centers for Medicare & Medicaid Services, hospitals, Medicare regulations, MedPAC|

CMS Takes First Steps Toward Medicaid DSH Cuts

Federal funds allocated to states to make Medicaid disproportionate share hospital payments (Medicaid DSH) payments would be reduced beginning in FY 2018 under a new rule proposed by the Centers for Medicare & Medicaid Services. The Medicaid DSH cuts, mandated by the Affordable Care Act but delayed several times at the behest of Congress, would come in the form of reduced Medicaid DSH allocations to individual states, with the size of those allocation cuts based on the nature of individual states’ Medicaid programs and changes in the number of uninsured patients in individual states. The cuts were established in the [...]

iqtsupport2017-07-31T06:00:34-04:00July 31, 2017|Centers for Medicare & Medicaid Services, hospitals, Medicaid|

CMS Shares Evaluation of Medicare-Medicaid Financial Alignment Efforts

In 2011 the Centers for Medicare & Medicaid Services launched a “Medicare-Medicaid Financial Alignment Initiative” that seeks “…to provide Medicare-Medicaid enrollees with a better care experience and to better align the financial incentives of the Medicare and Medicaid programs.” How is that initiative working so far? CMS recently released three reports that evaluate different aspects of the program. Those reports are: “Early Findings on Care Coordination in Capitated Medicare-Medicaid Plans under the Financial Alignment Initiative” “Beneficiary Experience: Early Findings from Focus Groups with Enrollees Participating in the Financial Alignment Initiative” “Issue Brief: Special Populations Enrolled in Demonstrations under the Financial [...]

iqtsupport2017-03-29T06:00:30-04:00March 29, 2017|Centers for Medicare & Medicaid Services, Medicaid, Medicare|

Participation in Alternative Payment Models Rises

In 2017 nearly 360,000 clinicians will participate in Medicare and Medicaid Alternative Payment Model programs sponsored by the Centers for Medicare & Medicaid Services. CMS also reports that this year 570 accountable care organizations, including 131 that bear risk, will serve more than 12.3 million Medicare and Medicaid beneficiaries. In addition, nearly 3000 primary care practices will participate in advanced primary care medical home models Find more about the growth of participation in CMS’s alternative payment models, including descriptions of the different models and breakdowns in the numbers of participants, in this CMS news release.

iqtsupport2017-01-27T06:00:22-05:00January 27, 2017|Accountable Care Organization, ACO, Centers for Medicare & Medicaid Services, Medicaid, Medicare|

HHS Transition Briefing Book Available

Prior to last November’s election, leadership at the U.S. Department of Health and Human Services prepared briefing materials for the transition staff of the winning candidate. That briefing book, HHS Presidential Transition Agency Landing Team Book, provides background material that HHS leadership believed would be useful for the incoming president’s transition team. That 118-page book is now publicly available; find it here.

iqtsupport2017-01-24T13:00:34-05:00January 24, 2017|Centers for Medicare & Medicaid Services|

Bundled Payments Reduce Hip, Knee Replacement Costs

Medicare’s bundled payment program for knee and hip replacements is reducing the cost of such treatments, a study has found. According to a new study in JAMA Internal Medicine, the Medicare bundled payment program, known as the Comprehensive Care for Joint Replacement program, has driven down the cost of the those joint replacements more than 20 percent or $5500 a case. Most of the savings have been derived through a significant decrease in the use of post-acute care, according to the study. This decrease occurred, moreover, at a time when Medicare spending on joint replacement rose five percent. Learn more [...]

iqtsupport2017-01-12T16:35:59-05:00January 12, 2017|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations|

CMS Beefs Up Home Health Regs

New home health regulations will “…improve the quality of health care services for Medicare and Medicaid patients and strengthen patients’ rights,” according to the Centers for Medicare & Medicaid Services, which published the new regulations. The new regulations call for a comprehensive statement of patient rights, better communication between patients and providers, data-driven assessment of the quality of care providers deliver, a stronger focus on infection control, better coordination of services with other providers, and new qualifications for home care personnel. Learn more about the new regulation in this CMS news release and in the regulation itself.

iqtsupport2017-01-11T13:00:42-05:00January 11, 2017|Centers for Medicare & Medicaid Services|

CMS Considers Expanding PACE

The federal government is considering expanding its Program of All-Inclusive Care for the Elderly to younger participants with disabilities. It also is considering expanded access to the program to as-yet unspecified “other populations.” The Centers for Medicare & Medicaid Services is seeking public input on these possibilities. To learn more, see this CMS news release, which outlines the agency’s interests and offers a link to its formal Request for Information seeking input on prospective PACE expansion. Comments are due February 10.

iqtsupport2017-01-11T06:00:18-05:00January 11, 2017|Centers for Medicare & Medicaid Services|