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Medicare

MSSP Proposed Rule may mean major changes for Medicare ACOs

MSSP Proposed Rule may mean major changes for Medicare ACOs

CMS recently released a Proposed Rule suggesting significant changes to the Medicare Shared Savings Program, aimed at accelerating the path for providers participating in a Medicare ACO to take on risk for the cost and care of their patient populations. The following is a summary of key changes proposed to the MSSP.

How to get paid for Remote Patient Monitoring with CPT Code 99091

How to get paid for Remote Patient Monitoring with CPT Code 99091

Two Final Rules issued by CMS in November 2017 opened up entirely new avenues for reimbursement of Remote Patient Monitoring services in 2018, creating the potential for better patient outcomes and a boost to a medical practice's bottom line.

The MACRA 2018 Proposed Rule: What does it mean for you?

The MACRA 2018 Proposed Rule: What does it mean for you?

Last week, CMS issued a Proposed Rule suggesting changes for Year 2 of the Quality Payment Program ("QPP"), established under the Medicare Access and CHIP Reauthorization Act of 2015. The changes are aimed at reducing administrative and financial burdens of the QPP on physician practices, particularly small independent practices and practices serving rural communities. Per CMS, the Proposed Rule "continues the slow ramp-up of the Quality Payment Program by establishing special policies for Program Year 2 aimed at encouraging successful participation in the program while reducing burden, reducing the number of clinicians required to participate, and preparing clinicians for the CY 2019 performance period."

MACRA for Physicians, Part Two

MACRA for Physicians, Part Two

Have you decided which MACRA participation option your practice will choose in the 2017 transition year? What you choose now (and how you implement) determines your payment adjustment for Medicare Part B billings in 2019 and beyond. In the second blog post of our MACRA series, we talk about the Merit Based Incentive Payment System (MIPS), and what it means for physicians.

MACRA for Physicians, Part One

MACRA for Physicians, Part One

The Final MACRA Rule relaxed the more stringent proposed requirements for 2017, so whether you choose to dip your toe in the water or take the full-on MACRA plunge, now is the time to get MACRA-ready and avoid reimbursement penalties. What does MACRA mean for your practice? That's a question we can help answer.

Top Changes to 2017 Medicare Physician Fee Schedule (MPFS)

Top Changes to 2017 Medicare Physician Fee Schedule (MPFS)

Last week, Nixon Law Group attended the Virginia Medical Group Management Association (VMGMA)‘s fall meeting in Williamsburg, and we were lucky enough to sit in on a session by the dynamic and talented Elizabeth Woodcock (of Woodcock & Associates). It was a whirlwind session on the key changes in the 2017 MPFS Proposed Rule, and we wanted to pass along all of the juicy details.

ALERT: MACRA and the Quality Payment Program (QPP) Proposed Rule

ALERT: MACRA and the Quality Payment Program (QPP) Proposed Rule

The biggest takeaway from this proposed Rule? Physicians should start planning for this change IMMEDIATELY to best position their practice for financial sustainability. This rule establishes the new Quality Payment Program (QPP) framework, which consists of two new pathways for provider evaluation and payment—the Merit-based Incentive Payment System (MIPS) and participation in Advanced Alternative Payment Models (APMs). The QPP stems from the changes passed as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), passed in April of last year. Participation in one of the QPP pathways will form the new basis for the level of payment for services Medicare Part B providers will receive. CMS will begin collecting data beginning in 2017. They will analyze the data for one year, and then use the data to adjust Medicare payments for eligible providers starting January 1, 2019.