The Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) finalized rules in conjunction with HHS' regulatory sprint to coordinated care. The OIG rule modifies safe harbor protections; CMS’ rule targets undue burden of the physician self-referral law, or Stark law.

The new options are detailed in a comprehensive table for each payment model. Notably, CMS will extend the Next Generation Accountable Care Organization model through December 2021.

A new proposed rule would extend the Comprehensive Care for Joint Replacement (CJR) model by three years and add outpatient knee and hip replacement to the definition of a CJR episode. Comments are due to CMS by April 24.

America’s Essential Hospitals said the federal Anti-Kickback Statute and Physician Self-Referral Law should be modified to remove barriers to coordinating care for the complex patients essential hospitals serve.

The final rules for Medicare’s Outpatient Prospective Payment System and Physician Fee Schedule for calendar year 2020 also expand access to opioid use disorder treatment and establish a prior authorization process for certain services.

The final rule includes provisions related to the Quality Payment Program, evaluation and management services, telehealth services, and the Medicare Shared Savings Program.

The updated resource library includes new fact sheets and guides for the Merit-based Incentive Payment System and Advanced Alternative Payment Models.

The proposed rules seek to eliminate barriers to promoting care coordination under current fraud and abuse laws; comments are due to the agencies Dec. 31.

To facilitate multi-payer alignment for ambulance services, the Center for Medicare and Medicaid Innovation will provide an interactive learning system with targeted learning opportunities for state Medicaid programs.

The Centers for Medicare & Medicaid Services announced new payment models through the Center for Medicare and Medicaid Innovation to promote high-quality, coordinated care for patients with chronic kidney disease.

The Centers for Medicare & Medicaid Services will accept applications for its second cohort of participants in the Bundled Payments for Care Improvement Advanced Model; second cohort participants will start model year three, beginning on Jan. 1, 2020.

The recently released 2017 Quality Payment Program Experience Report includes participation and performance statistics for the Merit-based Incentive Payment System and Advanced Alternative Payment Model tracks.

The tool includes 2018 Qualifying Alternative Payment Model (APM) Participant and Merit-based Incentive Payment System APM status.

More than 1 million eligible clinicians received a neutral or better payment adjustment in the first year of the Merit-based Incentive Payment System, one of two tracks in the Quality Payment Program.

The rule includes updates to the Quality Payment Program and documentation and payment changes for evaluation and management services.

In its comments, the association encouraged OIG to narrow the application of anti-kickback statute and beneficiary inducements civil monetary penalty laws to promote value and care coordination.

Participating entities, including 832 acute-care hospitals, will receive bundled payments for certain episodes of care to promote value in care delivery.

The Sept. 26 webinar will review requirements for submitting value-based payment approaches as an Other Payer Advanced Alternative Payment Model under the Medicare Access and CHIP Reauthorization Act of 2015.

In the rule, the Centers for Medicare & Medicaid Services continues a policy of reduced payments to new off-campus provider-based departments; the agency also provides updates to the Quality Payment Program.

The Centers for Medicare & Medicaid Services extended to Aug. 8 the participation agreement deadline for the Bundled Payments for Care Improvement Advanced model and announced that participants can retroactively withdraw from the program in March 2019.

This finalized rule provides flexibility in determining episode spending for Comprehensive Care for Joint Replacement model participating hospitals affected by a major disaster, such as a hurricane or wildfire.

The Centers for Medicare & Medicaid Services has issued a frequently asked questions document about the new voluntary bundled payment model ahead of the March 12 deadline for applications.

The table identifies which alternative payment models (APMs) are designated as Advanced APMs under the Quality Payment Program or the Merit-based Incentive Payment System.

Under the new payment model, a single bundled payment will cover services furnished by various providers across care settings. Participants can earn additional payment if they reduce costs over the course of a beneficiary’s 90-day episode of care while meeting quality benchmarks.

In response to an annual update to the Quality Payment Program, the association called for increased flexibility and risk adjustment for socioeconomic factors.