You’re a part of the Quality Payment Program in 2017 if you are in an Advanced APM or if you bill Medicare more than $30,000 in Part B allowed charges a year and provide care for more than 100 Medicare patients a year. More...
Medicare Access and CHIP Reauthorization Act of 2015MACRA is expected to drive care delivery and payment reform across the US health care system for the foreseeable future. Congress intended MACRA to be a transformative law that constructs a new, fast-speed highway to transport the health care system from its traditional fee-for-service payment model to new risk-bearing, coordinated care models. It has the potential to be a game-changer at all levels of our health care system. This page serves to be a one-stop shop for the latest on MACRA, including findings from our new 2016 Survey of US Physicians on their readiness for MACRA. More...
An Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, is a standardized notice that a health care provider/supplier must give to a Medicare beneficiary, before providing certain Medicare Part B or Part A items or services. Click HERE for further details.
This CMS MLN Connects® VIDEO presentation provides an overview of the Physician Quality Reporting System, or PQRS, and how your participation in PQRS in 2015 will determine how the Value-Based Payment Modifier will be applied to physicians’ reimbursement in 2017.
This GUIDE provides a general overview of the 2017 payment adjustments for the Centers for Medicare & Medicaid Services (CMS) Medicare quality programs. Learn how to meet quality reporting requirements, earn an upward, neutral, or downward adjustment based on performance under the Value Modifier, and avoid negative or downward payment adjustments in 2017 for the PQRS, EHR Incentive and Value Modifier programs.
This ARTICLE was revised on October 13, 2015, to correct a code in the Modified Codes – RARC table on pages 3-4. The code of N109 is now shown in that table, instead of the incorrect code of M109. All other information remains the same.
The annual HPSA bonus payment file for 2016 will be made available by the Centers for Medicare & Medicaid Services (CMS) to your MAC and will be used for HPSA bonus payments on applicable claims with dates of service on or after January 1, 2016, through December 31, 2016. Click HERE for additional info.
CMS Proposes Hospital Outpatient and Ambulatory Surgical Center Policy and Payment Changes, Including Proposed Changes to the Two-Midnight Rule, and Quality Reporting Changes for 2016. Click HERE for the Fact Sheets.
5% cut no longer on the table after reviewing feedback from 145 associations and provider organizations. Click HERE for the Results of AHCCCS Provider Rate Analysis.
Click HERE to read about the upcoming AHCCCS Provider Rate Reductions scheduled to take effect October 1, 2015. "AHCCCS encourages providers and other stakeholders to submit comments, to afford AHCCCS the opportunity to consider all relevant information in developing the rate changes."