Centers for Medicare & Medicaid Services

Proposal Would Equalize Medicare Physician Payments

All physicians would be paid equally for Medicare-covered office visits under a new proposal published recently by the Centers for Medicare & Medicaid Services. Under the proposed regulation, Medicare would collapse four levels of patient evaluation and management office visits, eliminate the extensive documentation required to justify the payments physicians seek, and pay one simple rate for office visits. CMS estimates that reducing the documentation requirements would save every doctor 51 hours a year. Some critics are concerned that specialists and those caring for especially ill or especially complex patients would be shortchanged by the proposed policy while others fear [...]

iqtsupport2018-07-24T06:00:47-04:00July 24, 2018|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations|

CMS Proposes Changes in Medicare Physician Payments

The Centers for Medicare & Medicaid Services has published a proposed regulation that it says …proposed historic changes that would increase the amount of time that doctors and other clinicians can spend with their patients by reducing the burden of paperwork that clinicians face when billing Medicare. The proposed rules would fundamentally improve the nation’s healthcare system and help restore the doctor-patient relationship by empowering clinicians to use their electronic health records (EHRs) to document clinically meaningful information instead of information that is only for billing purposes. Among the policy changes offered in the proposed 1743-page regulation governing Medicare physician [...]

iqtsupport2018-07-16T06:00:47-04:00July 16, 2018|Centers for Medicare & Medicaid Services, Medicare regulations|

With Eye on Value-Based Care, CMS Eyes Stark Law Change

Interested in addressing legal obstacles that prevent providers from participating in innovative payment models, the Centers for Medicare & Medicaid Services has put out a call for stakeholders to address challenges raised by the so-called Stark law that makes it difficult for physicians to participate in such models. In a news release accompanying CMS’s publication of its request for information, the agency notes that Over the past year, CMS has engaged with the provider community in a discussion about regulatory burden issues. This included publishing a Request for Information (RFI) soliciting comments about areas of high regulatory burden. One of [...]

iqtsupport2018-06-28T06:00:30-04:00June 28, 2018|Centers for Medicare & Medicaid Services, Medicare|

CMS Reports on Medicaid Long-Term Care Spending

The Centers for Medicare & Medicaid Services has issued a report on FY 2016 spending for Medicaid-covered long-term services and supports. The highlights of the $167 billion in state and federal spending include: Home and community-based services have accounted for almost all Medicaid long-term services and supports growth in recent years. Home and community-based services spending increased 10 percent in FY 2016, greater than the five percent average annual growth from FY 2011 through 2015. Institutional spending remained close to the FY 2010 amount. Institutional service spending decreased two percent in FY 2016 following an average annual increase of [...]

iqtsupport2018-06-08T06:00:16-04:00June 8, 2018|Centers for Medicare & Medicaid Services, Medicaid, Medicaid long-term services and supports|

CMS Introduces Medicaid “Scorecard”

The Centers for Medicare & Medicaid Services has unveiled a “scorecard” through which interested parties will be able to monitor outcomes for state Medicaid programs, state CHIP programs, and CMS itself while also comparing the performance of states to one another. The purpose of the scorecard, according to CMS, is “to modernize the Medicaid and CHIP program through greater transparency and accountability for the program’s outcomes.” CMS also explained that The first version of the Scorecard includes measures voluntarily reported by states, as well as federally reported measures in three areas: state health system performance; state administrative accountability; and federal [...]

iqtsupport2018-06-07T06:00:29-04:00June 7, 2018|Centers for Medicare & Medicaid Services, Medicaid|

CMS Mulls Direct Provider Contracting for Medicare

The Centers for Medicare & Medicaid Services is seeking public input on a proposal to permit Medicare beneficiaries to enter into direct contracts with primary care and multi-specialty providers. According to CMS, A DPC [direct provider contracting] model would aim to enhance the beneficiary-physician relationship by providing a platform for physician group practices to provide flexible, accessible, and high quality care to beneficiaries that have actively chosen this type of care model. The request for information, issued earlier this week, seeks public input on experience with direct provider contracting and asks interested parties to describe how Medicare might structure such [...]

iqtsupport2018-04-27T09:17:46-04:00April 27, 2018|Centers for Medicare & Medicaid Services, Medicare|

GAO: CMS Needs to Do Better Job on Demonstration Evaluations

The federal government needs to do a better job of evaluating Medicaid demonstration programs, according to the U.S. Government Accountability Office. Demonstration programs, on which the federal government spends more than $300 billion a year, exempt states from selected federal Medicaid requirements and regulations so they can test new approaches to providing and paying for care for their Medicaid population. As part of waiving these requirements, the Centers for Medicare & Medicaid Services requires the states to perform or commission evaluations of the effectiveness of those new approaches. According to a new GAO study, however, those reports are not always [...]

iqtsupport2018-02-22T06:00:25-05:00February 22, 2018|Centers for Medicare & Medicaid Services, Medicaid, Medicaid regulations|

Administration Slows Movement Toward Medicare Quality Payments

The Trump administration is slowing Medicare’s movement toward making greater use of quality in its payment system. The Obama administration’s goal of having 50 percent of Medicare payments made through a quality or alternative payment model by the end of 2018 now appears to be out of sight. Instead, the Centers for Medicare & Medicaid Services has partially canceled two bundled payment programs – one for joint replacement and another for cardiac rehabilitation programs – and announced that before introducing new programs it wants to take a closer look at the successes and failures of the alternative payment model programs [...]

iqtsupport2018-02-20T10:26:50-05:00February 20, 2018|Centers for Medicare & Medicaid Services, Medicare|

Medicaid Changes: More Than Just Work Requirements Coming?

While the green light for state applications to impose work requirements on their Medicaid recipients is receiving all of the attention, the Trump administration has issued guidance that appears to pave the way for other major changes in the Medicaid program as well. Specifically, the Centers for Medicare & Medicaid Services has issued guidance that will enable states to pursue section 1115 waivers to test different ways of serving Medicaid patients that are otherwise not permitted under federal Medicaid law, including: establishing time limits on how many months or years individuals may be enrolled in Medicaid; locking out for a [...]

iqtsupport2018-02-09T06:00:25-05:00February 9, 2018|Centers for Medicare & Medicaid Services, Medicaid, Medicaid regulations|

Administration Lays Groundwork for Medicaid Work Requirements

The Centers for Medicare & Medicaid Services has issued guidelines for states interested in adding a work requirement component to their Medicaid programs. With nearly a dozen states applying to implement controversial Medicaid work requirements, CMS has issued a guidance letter to state Medicaid directors outlining the criteria it will use when considering such applications. The new policy does not mandate work requirements in state Medicaid programs; it only presents the parameters CMS will use when considering the applications of states wishing to impose such requirements. For more information about the new policy, see the following resources: CMS’s news release [...]

iqtsupport2018-01-16T06:00:52-05:00January 16, 2018|Centers for Medicare & Medicaid Services, Medicaid|