Archive for: Proposed Rule

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Payment Innovation: Other

CMS Finalizes Hospital Transparency Requirements and Proposes Similar Policies for Certain Health Plans

In the latest response to the President’s Executive Order on Improving Price and Quality Transparency in American Healthcare, the Department of Health and Human Services released two rules related to requiring increased price transparency for hospitals and health plans.

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Payment Innovation: Quality Payment Program

CMS Hosting MIPS Value Pathways Webinar

CMS will host a webinar to discuss the MIPS Value Pathways as proposed in a CMS Request for Information appearing in the 2020 Medicare Physician Fee Schedule Proposed Rule.

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Payment Innovation: Quality Payment Program

CMS Solicits Comments on Proposed MIPS Cost Measures

CMS is proposing 10 episode-based cost measures and revisions to the current Medicare Spending per Beneficiary and Total per Capita Cost measures in the recently released 2020 PFS Proposed Rule.

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Payment Innovation: Other

Upcoming Medicare Learning Network Webinars

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

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Payment Innovation: Quality Payment Program

CMS Releases CY 2020 PFS Proposed Rule

On July 29, 2019, CMS released the CY 2020 Revisions to Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies (CMS-1715-P).

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Payment Innovation: Regulation

CMS Releases CY 2020 PFS, OPPS and ASC Proposed Rules

On July 29, 2019, CMs published the CY 2020 Proposed Rules for PFS, OPPS and ASC.

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Payment Innovation: Other

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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Payment Innovation: Other

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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Payment Innovation: Other

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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Diagnostics: Regulation

CMS Extends Comment Period on Proposed Changes to Proficiency Testing

The Centers for Medicare and Medicaid Services has extended the comment period on proposed changes to proficiency testing to June 4.

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Payment Innovation: Other

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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Payment Innovation: Other

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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Payment Innovation: Other

HHS and OIG Releases Proposal Targeting PBMs

HHS and OIG release proposed rule targeting pharmacy benefits managers.

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Diagnostics: Regulation

CMS Proposes Rule on Proficiency Testing

On February 4, 2019 CMS released the “Clinical Laboratory Improvement Amendments of 1988 (CLIA) Proficiency Testing Regulations Related to Analytes and Acceptable Performance” proposed rule on.

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Insurance Coverage: Regulation

Administration Releases Marketplace Proposed Rule

On January 24, 2019, the Centers for Medicare and Medicaid Services issued a proposed rule on payment parameters for the Health Insurance Marketplaces.

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Payment Innovation: Other

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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Insurance Coverage: Regulation

Exchange Program Integrity Proposed Rule

The Centers for Medicare and Medicaid Services issued a proposed rule on the Health Insurance Exchanges.

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Payment Innovation: Other

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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Payment Innovation: Regulation

CMS Releases Proposed Rule Overhauling Medicare Shared Savings Program

On August 9th, CMS released the Medicare Shared Savings Program proposed rule.

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Payment Innovation: Quality Payment Program

CMS Hosts QPP Conference Calls

The Centers for Medicare & Medicaid Services (CMS) is hosting two Quality Payment Program (QPP)-related conference calls.

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Insurance Coverage: Regulation

Association Health Plans Proposed Rule

The Centers for Medicare and Medicaid Services issued a proposed rule on Association Health Plans.

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Payment Innovation: Quality Payment Program

McDermottPlus Releases Hyperlinked Table of Contents of 2018 QPP Proposed Rule

An essential tool for a more efficient review of this critically important proposed rule

ORIGINAL ANALYSIS

Payment Innovation: Regulation

2018 Quality Payment Program Proposed Rule Lands at OMB

This week the Centers for Medicare Medicaid Services (CMS) sent the 2018 Quality Payment Program (QPP) Proposed Rule (CMS-5522-P) to the Office of Management of Budget (OMB) for review. Established through the Medicare Access and CHIP Reauthorization Act (MACRA), the QPP established two tracks for Medicare physician payment: the Merit-Based Incentive Payment System (MIPS) and…

ORIGINAL ANALYSIS

Payment Innovation: Regulation

CMS Drops 2018 MACRA Proposed Rule – Proposes Continuing Flexibilities for Year 2

On July 25, 2016 the Centers for Medicare and Medicaid Services (CMS) released a Proposed Rule for a new mandatory bundled payment model for cardiac care, an expansion of the Comprehensive Care for Joint Replacement (CJR) model and a Cardiac Rehabilitation (CR) incentive payment model. CMS also indicated that these proposed bundled payment models could…

ORIGINAL ANALYSIS

Payment Innovation: Regulation

Getting Lost in the MACRA Proposed Rule? M+ Table of Contents Can Help

On May 9, 2016 the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 Proposed Rule was published in the Federal Register.

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Payment Innovation: Regulation

Medicare Unveils Plan for New Medicare Physician Payment System

MACRA will impact millions of clinicians across all specialties that provide services to Medicare beneficiaries. This presentation is a guide to understanding the major components of this complex Proposed Rule in a brief and easily understandable format.

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Diagnostics: Regulation

Breaking: CMS Releases Anticipated PAMA 216 Regulations

The Centers for Medicare and Medicaid Services today posted the long-awaited proposed rule to implement section 216 of the Protecting Access to Medicare Act.

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