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CMS awards $100 million to help small practices succeed

The Centers for Medicare & Medicaid Services (CMS) has awarded $20 million to 11 organizations for the first year of a five-year project to provide on-the-ground training and education about the Quality Payment Program, established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), for clinicians in individual or small group practices. CMS intends to invest up to an additional $80 million over the remaining four years. Among the awardees are three California organizations: IPRO in San Francisco, Health Services Advisory Group in Glendale and Burlingame, and Qualis ...

Bills introduced to stop IPAB

California Congressman and physician Raul Ruiz, M.D., (D-Palm Springs) and Senate Finance Committee Ranking Member Ron Wyden (D-OR) recently introduced bills that that would prevent the Medicare Independent Payment Advisory Board (IPAB) from moving forward. IPAB was to be a 15-member federal agency with the task of achieving specified savings in Medicare without affecting coverage or quality. It was established by the Affordable Care Act and up until now has not been implemented. The board was charged with making recommendations to reduce per capita spending growth in Medicare if spending ...

Meaningful use reporting deadline pushed back two weeks to March 13

The Centers for Medicare & Medicaid Services (CMS) on Monday announced that physicians would have two additional weeks to register and attest to meaningful use for 2016 and avoid the 2018 penalty. Physicians now have until Monday, March 13, to attest for the 2016 reporting year. Two weeks ago, hospitals also received a similar reprieve. Physicians should note that CMS is only extending the attestation period, not the reporting period, so physicians must have concluded their reporting by December 31, 2016. Although the Medicare meaningful use program is being phased out ...

2017 Medicare EHR payment adjustment reconsideration forms due February 28

Eligible physicians who have been identified as being subject to Medicare electronic health record (EHR) payment penalties in 2017 (based on the 2015 reporting period), and believe that determination to be in error, have until February 28, 2017, to submit a reconsideration form to the Centers for Medicare and Medicaid Services (CMS). The reconsideration form can be downloaded from the CMS website. For reconsideration instructions, click here. If you have questions about the reconsideration process, please email pareconsideration@provider-resources.com. For more information on payment adjustments and hardship applications, or for information ...

CMS erroneously warns some physicians of 2017 meaningful use penalties

Providers who attested to meaningful use with the Medi-Cal Electronic Health Record (EHR) Incentive Program for program year 2015 are exempt from Medicare payment adjustments in 2017.  Because the California Department of Health Services pushed back the deadline to submit meaningful use applications for the 2015 program year to December 13, 2016, the agency was not able to send information to the Centers for Medicare and Medicaid Services (CMS) regarding 2015 Medi-Cal meaningful use attestations until late in December 2016.  For this reason, some Medi-Cal providers are now erroneously ...

Deadline extended to dispute 2015 PQRS and QRUR findings

The Centers for Medicare and Medicaid Services (CMS) recently released data that indicates which physicians will be subject to the 2017 payment penalties associated with the Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (VM) programs. Today, CMS announced that physicians who have concerns about the findings in their report(s) have until December 7 to file for an informal review of their data. The penalties in question stem from policies in effect prior to the enactment of the Medicare Access and CHIP Reauthorization Act (MACRA). Failure to successfully ...

2017 Medicare fee schedule includes $140 million in additional funding for primay care

The Centers for Medicare and Medicaid Services (CMS) on Wednesday released the final 2017 Medicare physician fee schedule. The fee schedule transforms how Medicare pays for primary care through a new focus on care management and behavioral health, which is expected to result in an additional $140 million in payments next year for physicians providing these services. The 2017 physician fee schedule focuses on improving Medicare payments for services provided by primary care physicians for patients with multiple chronic conditions, mental and behavioral health issues, and cognitive impairment or mobility-related ...

Don't forget: Last day to change your Medicare participation status for 2017 is December 31

Once again, it’s time for physicians to decide if they want to make changes to their Medicare participation status. Physicians have until December 31, 2016, to make changes for 2017. Although Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) penalties will not kick in until 2019, there are two more years of penalties that will be applied based on 2015 performance—tied to the meaningful use, Physician Quality Reporting System and Value-Based Modifier reporting programs. This will also decrease the limiting charge amounts that nonparticipating physicians can bill to ...

Physicians have until November 30 to dispute 2015 PQRS and QRUR findings

The Centers for Medicare and Medicaid Services (CMS) recently released data that indicates which physicians will be subject to the 2017 payment penalties associated with the Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (VM) programs. Physicians who have concerns about the findings in their report(s) have until November 30 to file for an informal review of their data. The penalties in question stem from policies in effect prior to the enactment of the Medicare Access and CHIP Reauthorization Act (MACRA). Failure to successfully complete required PQRS reporting ...

California GPCI fix implementation to begin in January

Last week, the Centers for Medicare and Medicaid Services (CMS) released the final Medicare physician fee schedule for 2017, which begins implementation of the long overdue overhaul of California’s outdated geographic payment localities. The California Geographic Practice Cost Index (GPCI) fix will update California’s Medicare physician payment regions and raise payment levels for 14 urban California counties misclassified as rural, while holding the remaining rural counties permanently harmless (starting in 2018) from cuts. All California payment localities will transition to Metropolitan Statistical Areas. The transition to the new localities starts next ...