Archive for: Proposed Rule

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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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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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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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