Archive for: FFS

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Payment Innovation: Other

CMS Announces CY 2021 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies

The final capitation rates are based on the National Per Capita MA growth percentage and the FFS growth percentage. CMS expects the average change in revenue will be 1.66%, an increase from the initial expected change in revenue of 0.93%.

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Payment Innovation: Innovation Center

Direct Contracting Office Hours on Feb 11

Center for Medicare and Medicaid Innovation (Innovation Center) will host office hours on the Direct Contracting model’s payment methodology.

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Payment Innovation: Other

CMS Reports on Rates of Social Determinants of Health Coding on FFS Claims in 2017

CMS began collecting data on SDOH through the use of z-codes in 2016.

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Payment Innovation: Other

CMS Seeks to Expand Services through Recent Coverage Decisions (Acupuncture for Low Back Pain and NGS for Advanced Breast and Ovarian Cancer)

Centers for Medicare and Medicaid Services has announced two coverage decisions that will provide access to previously uncovered services for Medicare FFS beneficiaries.

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Diagnostics

CMS Issues Decision Memo Broadening Coverage of Next Generation Sequencing Testing for Advanced Breast and Ovarian Cancer

CMS issues its decision memo that revises and expands on the coverage for next generation sequencing (NGS) as a diagnostic laboratory test for ovarian and breast cancer when selected criteria are met.

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Payment Innovation: Other

MedPAC Considers 2021 Payment Updates for Doctors and Hospitals and Discusses MA

MedPAC met on December 5, 2019, to discuss 2021 payment updates for physicians, inpatient and outpatient hospital services and the annual update on the status of MA as they prepare their annual March Report to Congress.

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Payment Innovation: Other

MedPAC Discusses MA Quality Program, MA Benchmarks and MSSP Post-Acute Care Spending at November Public Meeting

MedPAC met in Washington, DC on November 6-7, 2019. The Commission continued a discussion on redesigning the MA QBP.

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Diagnostics

CMS Issues Proposed Decision Memo on Reconsidered Next Generation Sequencing National Coverage Determination

CMS issues a proposed decision memo that would revise and expand on the coverage for next generation sequencing (NGS) as a diagnostic laboratory test for ovarian and breast cancer when selected criteria are met.

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Payment Innovation: Other

CMS Solicits Comments on the Future of Medicare Program Integrity

As a follow-up to the recently released Presidential Executive Order on Medicare, the CMS released two RFIs on the future of Medicare program integrity.

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