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Payment Innovation: Other

CMS Hosts Listening Session on Hospital Quality Star Rating System

CMS will host a listening session on Hospital Quality Star Rating System on September 19.

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CMS Brings Health Plan Quality Ratings to All Exchanges

For the first time CMS will require the display of the five-star Quality Rating System available nationwide for health plans offered on the Health Insurance Exchanges beginning in the 2020 Open Enrollment Period.

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GAO Requests HITAC Nominations

GAO is requesting nominations to the Health Information Technology Advisory Committee.

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Upcoming Medicare Learning Network Webinars

CMS will host a series of webinars on recently released payment and quality regulations.

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GAO Releases Report on Medicare Spending on Codes for Comprehensive Care Planning Services

The GAO recently released a report on Medicare physician spending on longitudinal comprehensive care planning services.

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Hospice Quality Reporting Program Online Courses Now Available

CMs uploaded two new resources regarding the Hospice Quality Reporting Program.

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CMS Holds Hospital IQR and Promoting Interoperability Programs Webinar

CMS will be hosting an education webinar for participants in the Hospital Inpatient Quality Reporting and Promoting Interoperability Programs.

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National Comprehensive Cancer Network Holds Summit on Quality in Cancer Care

The National Comprehensive Cancer Network is holding its oncology policy summit on September 12, 2019.

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2020 Medicaid and CHIP Core Set Open for Comments Through August 5

Recommendations for the 2020 Medicaid and CHIP Core Set are open through August 5.

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CMS Updates Medicaid and CHIP Scorecard

On July 18, 2019, CMS updated the data within the Medicaid and CHIP Scorecard.

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LAN Launches Roadmap APM Video Series

LAN launched a new educational video series covering the Roadmap for Driving High Performance in APMs.

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Proposal to Cover Acupuncture in Medicare

CMS is proposing coverage of acupuncture for Medicare patients with chronic low back pain in approved studies.

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MedPAC Releases 2019 Health Care Spending Data Book

On July 19, 019, MedPAC released their 2019 Health Care Spending and the Medicare Program data book.

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AHRQ National Advisory Council Meets July 24

The National Advisory Council for Healthcare Research and Quality will meet on July 24 to discuss people living with multiple chronic conditions.

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CMS Issues Updates to the Home Health Quality Reporting Program

CMS proposes changes to the Home Health Quality Reporting Program for CY 2020. The program currently has 19 reporting requirements.

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OIG Reports Find Hospice Deficiencies Posing Risks to Medicare Beneficiaries

OIG publishes two reports identifying significant vulnerabilities in the Medicare hospice benefit that are harming beneficiaries.

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Patient-Driven SNF Payment Model Will Go into Effect October 1, 2019

There is a hard transition between SNF payment models. All RUG-IV payments will end on September 30, 2019, and all PDPM payments will begin on October 1, 2019.

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HHS Seeking Participants for Quality Summit

HHS is seeking 15 industry stakeholders to join a summit responsible for drafting the Health Quality Roadmap required by President Trump’s recent Executive Order on health care transparency.

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Upcoming Health IT Advisory Committee Meeting on July 11

The Health IT Advisory Committee of the ONC is meeting on July 11 from 9:30 am to 12:30 pm ET.

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2018 Open Payments Data Now Available

On June 28, CMS released the 2018 Open Payments data.

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CMS Commits $50 Million to Assist States with Substance Use Disorder Treatment and Recovery

CMS released a Notice of Funding Opportunity for planning grants to address the opioid crisis.

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Call for Nominations for AHRQ National Advisory Council

AHRQ is seeking nominations for the National Advisory Council for Healthcare Research and Quality.

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GAO Appoints MedPAC Members

The GAO appointed new MedPAC members.

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MACPAC Chair and Vice Chair Appointed

The GAO appointed MACPAC’s Chair and Vice Chair.

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GAO Recommends CMS Improve Transparency Policy for Section 1115 Waivers

On May 17, the GAO released a report recommending an improved transparency policy for Section 1115 waivers.

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CMS Releases FY 2020 IPPS Proposed Rule

CMS calls for increased payments to rural hospitals and for new technologies in the recently released proposed rule.

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CMS Issues Final Rule for the 2020 Annual Notice of Benefit and Payment Parameters

CMs released the final rule for the 2020 annual Notice of Benefit and Payment Parameters.

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Medicare Spending Projected to Grow to 5.9 Percent of GDP by 2038

The Medicare Board of Trustees projected that Medicare spending will grow to 5.9 percent of GDP by 2038.

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Comment Period for Interoperability Rules Extended to June 3

HHS extended the comment period for two proposed interoperability rules to June 3.

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Quality Proposals from IRF, IPF and Hospice FY 2020 Payment Rules

CMS released proposed regulations for FY 2020 Medicare payment for IRF, IPF and Hospice.

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CMS Offers AI Health Outcomes Challenge Webinar

CMS is holding a webinar on the CMS Artificial Intelligence Health Outcomes Challenge on April 18.

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Quality and Safety of Nursing Home Care Under Scrutiny

The quality and beneficiary safety of nursing home care is under scrutiny.

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CMS Podcast on 2019 Quality Conference Now Available

CMS posted a podcast episode on the 2019 Quality Conference.

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CMS Releases Medicare Advantage Final Rate Notice and Call Letter

CMS released the final Rate Notice and Call Letter for Medicare Advantage.

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HRSA Announces Funding Opportunity to Test Network Approach to Rural Maternal Care

HRSA announces funding opportunity to test network approach to rural maternal care.

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CMS Announces Artificial Intelligence Health Outcomes Challenge

CMS announces the Artificial Intelligence Health Outcomes Challenge.

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CMS is Now Accepting Proposals for New Measures for the Medicare Promoting Interoperability Program

The CMS Annual Call for Measures for the Medicare Promoting Interoperability Program is now open.

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HCPLAN Hosts Webinar on APM Roadmap on April 3, 2019

HCPLAN to host webinar on APM roadmap on April 3, 2019.

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CMS Retires PQRS Website

CMS will retire the PQRS program website.

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CMS Accepting Proposals for New Measures for the Medicare Promoting Interoperability Program

The CMS Annual Call for Measures for the Medicare Promoting Interoperability Program is open.

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CMS Publishes Guidance on 1115 Waiver Evaluations

CMS published guidance for states on 1115 waiver evaluations.

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CMS Updates Drug Spending Dashboards

CMS updated its drug spending dashboards with 2017 data.

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CMS Holds Webinar on the Review, Dispute and Correction Periods for Open Payments Program

CMS will present a live Q&A session on March 27, 2019, for Open Payments system users. The session will open with a brief presentation on the review, dispute and correction periods, and the Open Payments team will be available to respond to any questions.

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Five Takeaways from March 2019 MedPAC Meeting

At their public meeting on March 7 and 8, MedPAC considered a range of Medicare payment issues. Our five takeaways from the meeting.

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CMS Extends Deadline to March 14 for Hospital IQR and the Promoting Interoperability Programs

The deadline for submitting eCQM data for the CY 2018 reporting period, pertaining to the FY 2019 payment determination, has been extended to March 14, 2019, at 11:59 pm PT.

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NQF Accepting Nominations and Soliciting Comments on Future Core Measure Sets

NQF Accepting Nominations for Opioid TEP, Patient & Caregiver Engagement Advisory Group and Soliciting Comments on Future Core Measure Sets

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CMS Updates Hospital Quality Info and Proposes Changes to Hospital Star Ratings

CMS has updated hospital performance data on the Hospital Compare website and on data.medicare.gov. The update included specific measures of hospitals’ quality of care, many of which are updated quarterly, and the Overall Hospital Star Ratings, which were last updated in December 2017.

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AHRQ Grant Announcement to Advance a High Valued Healthcare System

AHRQ is interested in receiving health services research grant applications to advance the national goal of achieving a high value healthcare system in support of the Health and Human Services Value-Based Transformation Initiative.

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CMS Hosts Listening Session on Interoperability and Patient Access Proposed Rule

CMS will host a listening session on the Interoperability and Patient Access Proposed Rule.

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CMS Approves Drug Price Negotiations for Colorado Medicaid

Colorado has become the latest state to receive approval from CMS for negotiating drug prices for Medicaid recipients using value-based contracting arrangements.

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CMS Launches Podcast

CMS launches “CMS: Beyond the Policy,” a new podcast highlighting updates and changes to policies and programs.

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Call for Nominations: Measure Applications Partnership

The Call for Nominations for organizations and individual subject matter experts to serve on the Measure Applications Partnership is open.

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Grassley Queries CMS on Update of Recovery of Improper EHR Incentive Payments

In a letter to CMS, Senate Finance Chairman Chuck Grassley (R-IA) pressed the agency for an update on their recovery of improper electronic health record incentive payments.

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Senators Cassidy and Warner Introduce PAVE Act

Senators Cassidy and Warner Introduce Patient Affordability, Value and Efficiency (PAVE) Act.

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Bipartisan House and Senate Letters in Support of Medicare Advantage

The House and Senate sent letters to Centers for Medicare and Medicaid Services Administrator Seema Verma in support of the Medicare Advantage program.

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ONC Releases Proposed Rule to Advance Interoperability

ONC releases proposed rule to implement certain provisions of the 21st Century Cures Act.

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New Resource: FY 2019 IPPS Promoting Interoperability Factsheet

CMS publishes factsheet as companion to final IPPS rule.

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HHS and OIG Releases Proposal Targeting PBMs

HHS and OIG release proposed rule targeting pharmacy benefits managers.

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CMS Launches App on What Original Medicare Covers

CMS launches new app called “What’s Covered” that tells users whether Medicare covers a specific medical item or service.

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CMS Restarts Open Payment Webinar Series

CMS announces the return of Wednesday Webinars, presented by the Open Payments team.

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MedPAC Scheduled to Discuss MSSP on January 18

MedPAC is scheduled to discuss an analysis of the Medicare Shared Savings Program at their public meeting on January 17-18, 2019.

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GAO Releases Report on Challenges to Electronically Matching Patients’ Records Across Providers

GAO released a report required by the 21st Century Cures Act detailing the challenges to electronically matching patients’ records across providers.

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CMS Hosts Webinar on ESRD Quality Incentive Program

CMS will host a webinar on January 15 from 2 to 3 pm ET on the End-Stage Renal Disease Quality Incentive Program.

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MSSP Final Rule Seeks to Accelerate Move to Performance-based Risk in Traditional Medicare

CMS published a final rule on December 31, 2018, that overhauls the Medicare Shared Savings Program and takes a new approach to transitioning providers to performance-based risk arrangements in traditional Medicare.

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CMS to Create New Office for Regulatory Reform

CMS Administrator Verma announced that the agency will be creating an office for regulatory reform. Once established, the purpose of the office will be to reduce “regulatory burden” for providers and other stakeholders created by CMS programs.

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HHS Releases HIPAA RFI

HHS has released a request for information about how HIPAA rules could be modified to further the Secretary’s goal of promoting coordinated care. Comments are due February 11, 2019.

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HHS Announces CHPL Data Challenge Winners

ONC announces winners of the Certified Health IT Product List (CHPL) Data Challenge.

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MedPAC Considers Draft Recommendation to Revamp Hospital Value Based Purchasing Program

MedPAC considers draft recommendation to revamp the Hospital Value Based Purchasing Program.

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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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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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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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