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Payment Innovation: Other

Administration Releases Report on Healthcare Competition

Departments of Health, Treasury and Labor release report titled “Reforming America’s Healthcare System Through Choice and Competition.”

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CMS Releases Procedure Price Look-Up Tool for Services Performed in the OPPS and the ASC

CMS launches new online tool that allows consumers to compare Medicare payments and copayments for certain procedures that are performed in both hospital outpatient departments and ambulatory surgical centers.

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ONC Releases Draft Strategy to Reduce Health IT Burden

On November 28, 2018, the Office of the National Coordinator for Health IT released a draft strategy to help reduce administrative and regulatory burden on clinicians caused by the use of health information technology.

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FY 2019 HVBP Results Released: Most Hospitals Will See Modest Adjustments to their IPPS Payments

CMS released FY 2019 results from the Hospital Value Based Purchasing Program.

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Hargan Announces Innovation and Investment Summit Core Participants

HH) announces core participants in the Deputy Secretary’s Innovation and Investment Summit.  The first meeting is December 18, 2018.

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CMS Proposes Changes for MA and Part D Plans: Coverage Changes for Protected Class Drugs, Step Therapy Requirements and Greater Price Transparency for Medicare Beneficiaries

On November 26, 2018, CMS released a proposed rule that would allow for changes in 2020 to coverage of protected class drugs, establish new requirements for when MA plans may apply step therapy as a utilization management tool for Part B drugs and implement electronic tools to increase drug price transparency for Medicare beneficiaries.

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CMS Hosts Webinars on Clinical Quality Language Basics on Nov. 27 and Nov. 29

CMS will host a webinar on November 27, 2018 from 12 to 1 pm ET introducing the Clinical Quality Language logic expression language.

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ONC Holds 2018 Annual Meeting on Nov. 29

The Office of the National Coordinator for Health Information Technology will hold their 2018 Annual Meeting from November 29 ­to 30 in Washington, DC.

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MedPAC Discuss Advanced APMs and Other Value-based Issues at November 2018 Meeting

MedPAC discussed a number of topics at its November meeting, including Advanced APMS.

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Institute for Medicaid Innovation Survey Finds Medicaid MCOs Are Increasingly Using Value-based Payment Models

Survey results released by the Institute for Medicaid Innovation find that around half of Medicaid managed care organizations launched population-specific value-based purchasing models last year, and around 10 percent of plans had extensive value-based purchasing arrangements in place.

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CMS Releases Proposed Rule on Medicare Advantage, Medicare Part D, PAC and Medicaid

CMS releases proposed rule implementing certain provisions of the Bipartisan Budget Act of 2018.  Under this proposed rule, MA plans would be able to offer telehealth benefits beyond what is currently allowable under the traditional Medicare telehealth benefit.

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LAN Releases Updated Report on APM Adoption

Health Care Payment Learning and Action Network released a new report on alternative payment model adoption.

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ASPE’s Social Risk Request for Information

RFI released seeking provider and plan approaches to improve care for Medicare beneficiaries with social risk factors.

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Payment Innovation: Other

MedPAC Releases 2018 Payment Basics – A Series of Briefs on the Various Medicare Payment Systems

MedPAC releases 2018 Payment Basics, a series of briefs on the various Medicare payment systems.

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CMS Announces Changes to the Oversight of Medicare Accrediting Organizations

CMS announces a number of changes to the oversight of Medicare Accrediting Organizations. CMS believes these changes will improve quality and safety in healthcare facilities and empower patients with information to make decisions about where to receive care.

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CMS Releases 2019 Medicare Advantage and Part D Prescription Drug Quality Program Star Ratings

CMS has released Part C and Part D Star Ratings; providing information about the quality of plan choices.

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MedPAC Considers Episode-based Payments for Post-Acute Care

MedPAC will consider a staff analysis of two aspects of a stay-based unified prospective payment system (PPS) for post-acute care at its October meeting.

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GAO Makes Appointments to PCORI Governing Board

GAO announces PCORI board member appointments.

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Senate Hearings on Health Care Costs

Senate HELP Committee to hold hearings on health care costs.

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GAO Recommends that DOD Use Common Key Quality Measures

GAO recommends that for all providers, the DOD use common key quality measures, expand their range, and develop consistent performance standards and requirements.

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MedPAC to Discuss Mandated Report on Clinician Payment in Medicare at September 6th Meeting

MedPAC is scheduled to discuss a mandated report on clinician payment examining the relationship between Medicare’s payments to clinicians and the supply of and quality of care provided by those clinicians report at their September 6, 2018, meeting.

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OIG Releases Request for Information on Anti-Kickback Statute and Beneficiary Inducements

The OIG published a request for information seeking stakeholder input on potential new safe harbors to the Anti-Kickback Statute and exceptions to the beneficiary inducement prohibition in the Civil Monetary Penalty Law to remove impediments to care coordination and value-based care.

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Payment Innovation: Other

CMS Administrator Seema Verma Releases Letter to Doctors

Solicits feedback from clinicians on proposal to overhaul E/M documentation, billing and payment

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CMS Hosts Webinar on Public Reporting on Physician Compare

July 24, 2018 11:00 AM ET/8:00 AM PT and July 26, 2018 3PM ET/12:00 PM PT

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LAN Spring Forum: Aligning for Action

LAN Hosts Virtual Forum on May 1, from 1-3:30 PM ET

ORIGINAL ANALYSIS

Payment Innovation: Other

ONC Releases RFI on Establishing Metrics to Assess Interoperability

ONC releases RFI regarding Assessing Interoperability for MACRA. Comments are due on June 3, 2016. 

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LAN Releases Final APM White Paper

On January 12, 2016 the Health Care Payment Learning & Action Network (LAN) released the final Alternative Payment Model (APM) Framework White Paper. The paper defines payment model categories and establishes a common framework and a set of conventions for measuring progress in the adoption of APMs.

ORIGINAL ANALYSIS

Payment Innovation: Other

CMS Releases RFI on the Implementation of MIPS and the Promotion of Alternative Payments Models

On September 28, 2015, the Centers for Medicare and Medicaid Services (CMS) released Request for Information (RFI) on the Implementation of the Merit-based Incentive Payment System (MIPS), Promotion of Alternative Payment Models (APMs) and Incentive Payments for Participation in Eligible APMs (CMS-3321-NC).

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