CMS rings in the new year with overhaul of MSSP ACOs

By Thomas Dowdell (US) and Joseph Keillor (US) on January 3, 2019 Posted in News from DC

On December 21, 2018, CMS issued a mammoth 957 page “Pathways to Success” final rule, which overhauls shared savings/losses tracks for Medicare Shared Savings Program Accountable Care Organizations (MSSP ACOs) to push ACOs into shared risk models more quickly, among other program changes. Largely consistent with the proposed rule as we summarized here, the final … Continue reading

CMS issues 2018 Medicare physician fee schedule final rule and MACRA physician QPP final rule

By Thomas Dowdell (US) on November 3, 2017 Posted in News from DC

On November 2, 2017, the Centers for Medicare & Medicaid (CMS) Services issued its Calendar Year (CY) 2018 Medicare Physician Fee Schedule (MPFS) final rule. The overall update to payments under the MPFS in 2018 will be +0.41 percent. The 2018 MPFS conversion factor will be $35.99, an increase from $35.89 in 2017. MPFS payment … Continue reading

MACRA: Advanced APMs and MIPS Replace SGR Effective January 2017

By Thomas Dowdell (US), Mark Faccenda (US), Wendy Wright (US), Chaula Mehta (US), Lidia Niecko-Najjum (US) and Blake Walsh (US) on October 19, 2016 Posted in Regulatory

On October 14, 2016, CMS issued the “Merit-based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models” final rule with comment period. MIPS and Advanced APMs are the two ways for health care providers to participate in the CMS Quality Payment Program that … Continue reading