24 Apr 2019

CMS OUTLINES NEW PRIMARY CARE PAYMENT MODELS AIMED AT GREATER SHARED RISK APRIL 22

      The U.S. Centers for Medicare & Medicaid Services has proposed changes with several new primary care payment models, including one that would shift providers to global payments. The Trump Administration says it is building on the progress made over the last two years and further the CMS priority

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14 Dec 2018

VOLUNTARY MACRA CODES MAY DETERMINE WHAT DOCTORS ARE PAID

New patient relationship categories and codes are one of the most important provisions of the Medicare Access and CHIP Reauthorization Act (MACRA), according to a piece in the New England Journal of Medicine. In January 2018, the billing-code modifiers, which allow clinicians to report their relationship to a patient at a

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06 Nov 2018

CMS RELEASES FINAL 2019 PHYSICIAN FEE SCHEDULE NOV. 1

The Centers for Medicare & Medicaid Services (CMS) released the final 2019 Physician Fee Schedule (PFS) and the Quality Payment Program (QPP) rule Nov. 1. According to CMS officials, the final rule modernizes Medicare payment policies to promote access to virtual care, saving Medicare beneficiaries time and money while improving

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02 Nov 2018

CMS DELAYS PROPOSED CHANGES TO E/M CODES IN FINAL RULE UNTIL 2021

The Centers for Medicare and Medicaid Services has proven that “final rules” are not always final. In response to complaints from physicians, CMS has delayed major changes to E/M codes until 2021. While CMS moved ahead with parts of its plan to consolidate codes for Medicare patient visits, it made

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01 Nov 2018

WISCONSIN MEDICAID WORK PROGRAM GETS CMS OK OCT. 31

The Centers for Medicare & Medicaid Services (CMS)  approved a waiver to implement work requirements in Wisconsin’s Medicaid program Oct. 31, making it the fourth state to enact such an approach.   Under the waiver, beneficiaries in the state’s BadgerCare program would have to engage in 80 hours a month of “community

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01 Nov 2018

HHS ANSWERS YOUR QUESTIONS ABOUT THE IPI DRUG PRICING MODEL

    By: Dan Best SEE RELATED ARTICLE: http://www.veintherapynews.com/wp-admin/post.php?post=1557&action=edit   Last week, as part of fulfilling President Trump’s promise to lower drug prices and cut down on foreign governments’ freeriding, HHS put forth a new way of paying for physician-administered drugs within Medicare, the International Price Index (IPI) Model. The model aims to:

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31 Oct 2018

CMS SEEKS COMMENT ON PROPOSED RULE TO USE IPI PAY MODEL BY DEC 31

The Centers for Medicare & Medicaid Services intends to test whether phasing down the Medicare payment amount for selected Part B drugs to more closely align with international prices will meet President Trump’s blueprint to lower drug costs and reduce out-of-pocket costs for patients. CMS is soliciting public comments by

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18 Oct 2018

24 MEDICARE ADVANTAGE PLANS AND 27 MEDICARE PART D DRUG PLANS AVAILABLE DURING 2019 OPEN ENROLLMENT PERIOD

With Medicare Advantage playing an increasingly larger role in Medicare, the average person on Medicare will be able to choose among 24 plans during the annual Medicare open enrollment period that began Oct. 15, according to a new analysis from KFF (the Kaiser Family Foundation). The new analysis, Medicare Advantage

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09 Oct 2018

CMS ANNOUNCES PARTICIPANTS IN NEW VALUE-BASED BUNDLED PAYMENT MODEL

  On Oct. 9, the Centers for Medicare & Medicaid Services (CMS) announced that 1,299 entities have signed agreements with the agency to participate in the Administration’s Bundled Payments for Care Improvement – Advanced (BPCI Advanced) Model.  The participating entities will receive bundled payments for certain episodes of care as

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28 Sep 2018

SEEMA VERMA SPEECH: CMS TO BEGIN AUDITS ON MEDICAID INSURERS

Seema Verma, Centers for Medicare & Medicaid Services Administrator, issued a warning to Medicaid plan sponsors on Thursday, warning the agency would begin unscheduled targeted financial audits. The warning came at the 2018 Medicaid Managed Care Summit during a speech Verma delivered in which she vowed to bring more transparency to

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