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Clinicians can participate in the first year of the Merit-based Incentive Payment System and avoid a negative payment adjustment if they begin collecting data by Dec. 31.

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Discover how NYC Health + Hospitals, a 2017 Gage Award winner, began universal depression screening for adults and implemented collaborative care for depression in the primary care setting.

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In response to a proposed annual update to the Quality Payment Program, America’s Essential Hospitals offered recommendations related to the merit-based incentive payment system.

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The first performance year was set to begin Jan. 1, 2018; America’s Essential Hospitals previously expressed concern about the scope and pace of the models.

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The association says providers selected for the Comprehensive Care for Joint Replacement (CJR) demonstration are only just now adapting to the new payment and delivery approaches and need more time before facing another demonstration.

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Participants learned about the evolution of Medicaid Managed Care and how essential hospitals can succeed in the changing environment from experts at Premier Inc.

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Aids provided by the Centers for Medicare & Medicaid Services include fact sheets and overview documents, lists of alternative payment models, webinars and other educational tools, and support contacts.

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CMS proposes changes related to participation in the merit-based incentive payment system or Advanced Alternative Payment Models tracks.

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CMS predicts nearly all clinicians in advanced alternative payment models in 2016 would qualify for a 2019 incentive payment for participating in 2017.

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A new Centers for Medicare & Medicaid Services guide highlights technical resources for clinicians participating in the Quality Payment Program under MACRA.

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The first performance year for new cardiac episode payment models and the effective date of joint replacement regulation amendments now starts Jan. 1, 2018.

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An initiative aims to convene and support an essential providers network to promote payment and delivery reform amid uncertainty surrounding health policy.

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Over a five-year period, CMS will test the three-track AHC model, which aims to support health-related social needs of Medicare and Medicaid beneficiaries.

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The agency estimates that MA organization payment rates will increase by 0.45 percent on average in 2018, with an expected average revenue increase of 2.95 percent when accounting for coding changes.

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The delay, which applies to certain hospital outreach labs, comes after stakeholders expressed concerns about the March 31, 2017, deadline.

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The rule affects the Advancing Care Through Episode Payment Models, the Cardiac Rehabilitation Payment model, and changes to the CJR model.

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CMS projects that Medicare Advantage organization payment rates will increase by 0.25 percent in 2018.

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OIG found that the federal portion of spending on catastrophic coverage reached $33.2 billion in 2015, compared with $10.8 billion in 2010.

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CMS also expanded the Comprehensive Care for Joint Replacement (CJR) model to include surgical hip/femur fracture treatment.

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New guidance describes how off-campus hospital provider-based departments can maintain their grandfathered status when relocating due to extraordinary circumstances.

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A CMS spokesperson said the project was pulled after the agency reviewed public comments — there were more than 1,300 comments submitted, mostly negative.

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The agency released software that will help developers build applications for clinicians and their practices and make it easier for organizations to retrieve and maintain QPP measures using the Explore Measures section of the QPP website.

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Join us to discuss the policies, outlined by CMS, for the implementation of the site neutral law.

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In the rule, CMS revised its earlier position not to direct any physician fee schedule payments to non-grandfathered, off-campus hospital clinics in 2017 and, instead, established a 50 percent interim rate.

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While the final rule provides some relief from onerous proposed payment policies, it continues to put underserved communities at risk of further declines in access to care, the association says.

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The guide gives states information they need to develop actuarial rate certifications, such as benefit cost projections, pass-through payments, and risk mitigation strategies.

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With the opportunities, clinicians potentially could earn a 5 percent incentive payment for a growing list of alternative payment models in 2017 and 2018.

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An Oct. 14 final rule establishes a new approach to physician payment required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA): the Quality Payment Program.

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The rule establishes a "transition year," as well as flexibility for providers to choose their participation pace.

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The Medicare Access and CHIP Reauthorization Act of 2015 requires CMS to remove Social Security numbers from beneficiaries’ Medicare cards by April 2019.

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In May, CMS paused initial patient status reviews to ensure reviews are performed consistently and the two-midnight policy is properly applied.

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A per-capita cap would allow the federal government to limit Medicaid spending by allocating a specific amount of funding based on states' enrollees.

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CMS Acting Administrator Andrew Slavitt announced the reporting options providers have to ensure they do not face a negative payment adjustment in 2019.

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CMS is seeking feedback on how to help states implement innovative payment, care delivery models consistent with MACRA's proposed Quality Payment Program.

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Hospitals and other providers generated more than $466 million in savings in 2015 through participation in Medicare accountable care organizations (ACOs).

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CMS is concerned that some providers might steer Medicare- and Medicaid-eligible patients into individual market plans to get higher payments.

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Review contractors will be able to use coding specificity as the reason for an audit or a denial of a claim to the extent that they did before Oct. 1, 2015.

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CMS will issue future rulemaking to further restrict new or increased pass-through payments under Medicaid managed care plan contracts.

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Several members of America’s Essential Hospitals are among the participants selected for the Million Hearts Cardiovascular Disease Risk Reduction Model.

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CMS recently proposed policies for implementing the site neutral law – join us July 26 to discuss the impacts this will have on your hospital.

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Under the models, hospitals would be financially accountable beginning July 1, 2017, for meeting quality and cost measures for the entire episode of care.

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Join us to hear CMS’ perspective on the finalized rule to modernize Medicaid and the Children’s Health Insurance Program managed care regulations.

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America's Essential Hospitals denounces the Centers for Medicare & Medicaid Services decision to limit flexibility and withhold hospital payments for new, off-campus hospital outpatient departments.

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Centers for Medicare & Medicaid Services' narrow interpretation of Section 603 of the Bipartisan Budget Act of 2015 threatens to reduce access to badly needed health care services in the nation's most underserved communities.

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The agency says the proposed changes are intended to reduce a backlog of Medicare payment and coverage determination appeals.

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The new CMS rate development guide outlines various provisions of the recent Medicaid managed care final rule that affect the rate-setting process.

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Learn more about the Centers for Medicare & Medicaid Services’ final rule to modernize Medicaid and Children’s Health Insurance Program managed care regulations.

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Erica Murray discussed the major elements of the new Public Hospital Redesign and Incentives in Medi-Cal program.

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Delay of patient status reviews will continue until further notice. The agency will work with Quality Improvement Organizations to ensure the two-midnight policy is enforced consistently for all hospitals.

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The proposed rule includes key provisions for carrying out a new physician payment system to replace Medicare's sustainable growth rate updates.

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Hospitals and other providers now have until May 20 to submit a letter of intent for the Next Generation ACO model, which carries greater risk but also offers greater rewards; applications are due May 25.

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The proposal would reverse the cut starting in FY 2017, in addition to a temporary adjustment to retroactively pay for reduced payments from fiscal years 2014 to 2016.

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Changes will more accurately reflect cost of care for dual eligibles and adjust Medicare Advantage star ratings for enrollees' socioeconomic and disability statuses.

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In letter to CMS, association raises issues of payment, definition of off-campus outpatient department of a provider, and 340B eligibility.

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Hospitals and other providers now have until May 2 to submit a letter of intent to participate in the second and final round of the Next Generation Accountable Care Organization (ACO) Model.

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Department calls for interagency approach that employs alternative payment models and better communication between patients and providers.

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Proposed Medicaid managed care regulations effectively would end supplemental payments that have been in effect for at least a generation to many essential hospitals.

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Changes allow IHS and tribal facilities to enter into care coordination agreements with non-IHS/tribal providers to furnish certain services for AI/AN Medicaid beneficiaries.

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The National Safety Net Advancement Center at Arizona State University has announced virtual learning collaboratives and grant funding of up to $80,000 for hospitals working to overcome payment and care delivery reform challenges.

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New clinical quality measure sets for physicians were created in collaboration with stakeholders to increase multipayer alignment, while reducing cost and administrative burden. The core measure sets will inform the implementation of MACRA.

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Providers now must report and return a Medicare Part A or B overpayment to CMS by the later date of 60 days since identification or the corresponding cost report due date. The final rule also establishes a six-year lookback period.

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The new FAQ clarify that site neutral law won't impact PO modifier requirements. PO modifiers must be included on claims as of Jan. 1 for all services and items furnished in off-campus, provider-based departments.

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Comments urge CCIIO to require that ACA marketplace plans include willing essential community provider (ECP) hospitals and ensure payment rates support access to care.

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First of five consensus reports from National Academy of Medicine (NAM) ad hoc committee identifies social risk factors for Medicare payment and quality programs, and the measures they can impact.

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New members include six who will serve three-year terms and one who will serve the remaining two years of a vacant seat; GW health policy expert Sara Rosenbaum was named chair.

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Agency to give hospitals opportunity to comment on law's requirements for notifying Medicare beneficiaries when outpatient observation services last longer than 24 hours.

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Hospital performance data for FY 2016 available on Hospital Compare; hospitals in bottom quartile face 1 percent Medicare payment cut.

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Court-ordered justification provides additional insight for 0.2 percent inpatient payment rates cut agency linked to policy

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Essential hospitals 2.67 times more likely than other hospitals to receive penalties under Medicare readmissions program in FY 2016

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Agency to host Nov. 30 webinar to provide information and answer questions about the bundled payment model for hip and knee replacement.

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Hospitals paid under IPPS in 67 metropolitan statistical areas will be required to participate in new payment model starting in April 2016

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Rule for Medicaid FFS omits hospitals from the list of services for which a state must evaluate access. Comments on rule due Jan. 4.

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Changes include reducing OPPS payment by 0.3 percent, relaxing two-midnight policy requirements, and updating OQR measures.

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The Basic Health Plan methodology would begin Jan. 1, 2017, and is largely unchanged from current methodology. CMS plans to finalize the rule in Feb. 2016. The BHP is an affordable alternative to marketplace coverage.

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Feedback due Nov. 17 on provisions to implement MIPS and APM participation incentives; MIPS quality measures of particular interest to hospitals

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CMS requests feedback on a range of provisions relating to MIPS and incentives for participation in APMs, including whether to stratify quality measure data by demographic factors.

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Medicaid managed care payment rates must be certified by an actuary, appropriate for the covered population and services, and developed in accordance with generally accepted actuarial practices and principles.

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In a legal victory for hospitals, a district court said CMS did not meet legal requirements for rulemaking when it cut hospital inpatient payments by 0.2 percent in FY 2014. The court ordered CMS to reissue the FY 2014 IPPS rule.

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The webinars will feature representatives from CMS answering questions about the model. Instructions on how to submit questions will be included in the registration confirmation email.

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CMS has extended the deadline for the Million Hearts: CVD Risk Reduction Model due to high interest. The model will incentivize providers to target Medicare beneficiaries with the highest risk of CVD for patient-centered care.

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Association calls on CMS to consider the readiness of essential hospitals and challenges of caring for the vulnerable, and risk-adjust for SDS, in finalizing its proposed rule for new CCJR payment model.

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This conference call will cover major policies included in the IPPS and LTCH PPS final rule, including quality initiatives. Question and answer period to follow presentation.

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The Million Hearts: CVD Risk Reduction Model will incentivize providers to calculate CVD risk for Medicare beneficiaries and target those with the highest risk for patient-centered care.

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In comments on the CY 2016 OPPS proposed rule, the association calls on CMS to consider the unique challenges of caring for the most vulnerable, including in relation to the two-midnight policy and ambulatory payment classification.

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Pioneer and MSSP ACOs showed improvement in at least 27 of 33 quality measures in last reporting period. More than 420 Medicare ACOs have been established, coordinating care for more than 7.8 million patients.

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RACs will not conduct postpayment reviews of patient status for Medicare claims with an inpatient admission between Oct. 1 and Dec. 31, 2015.

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Agency resource, in preparation for Oct. 1 transition to ICD-10, can help providers determine how to accurately report codes.

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Institute researcher discusses the popular and up-and-coming movements in delivery system transformation and alternative payment models.

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Updated guidance clarifies what codes will be accepted by CMS during one-year grace period, including examples of a code family.

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Comments urge CMS for flexibility, the allowance of certain direct payments, and regulations that reflect states' ability to achieve broader policy goals through the Medicaid Program.

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Proposed CCJR model would bundle Medicare payments to acute care hospitals for hip and knee replacement surgery in 75 metropolitan statistical areas; hospitals would be held financially accountable for meeting quality and cost targets for entire episode of care.

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Proposed rule would update physician payment rates for Medicare services, change physician quality programs, and solicit comment on MACRA requirements.

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Agency proposes to reduce slightly payment rates for hospital outpatient services, relax some provisions of the two-midnight policy, and update quality reporting measures.

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Member panel will exchange information, advise association on recent CMS proposal to restrict states' ability to direct supplemental payments; please express interest by July 17.

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Agency says that for one year it will not deny inaccurate claims as long as the code listed is from the correct code family.

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Join us to learn more about the ICD-10 coding system, how the transition will impact your hospital, and what you can do to prepare.

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Upfront and ongoing savings aim to encourage providers to form ACOs in rural and underserved areas and promote participation in models with greater financial risk. Applications accepted July 1 to July 31.

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Comments caution CMS about Medicare DSH payment cuts and urge CMS to ensure measures and methodologies used in quality reporting programs are adjusted for sociodemographic factors.

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MACPAC's report to Congress touts potential of DSRIP programs to transform Medicaid reimbursement and improve health outcomes, also addresses the challenge and calls for clear and consistent federal guidance.

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Nominations are due June 19. The work group will define terms related to alternative payment models and a strategy to track progress of APM implementation.

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Learn more about how federal pressure and changes in law will force physicians to adapt to various payment models over the next several years.

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Annual release includes 2013 data related to the 100 most common diagnoses for Medicare patients requiring inpatient stays and 30 selected outpatient procedures.

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New law replaces sustainable growth rate with new update schedule and creates quality reporting and merit-based payment systems

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The Million Hearts: CVD Risk Reduction Model will incentivize providers to calculate cardiovascular risk for eligible Medicare beneficiaries and target those with the highest risk for patient-centered care. Applications are due Sept. 4.

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Proposed rule would better align regulations with those for commercial, health insurance marketplace, and Medicare Advantage plans

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Roughly 48 percent of participating ACOs produced $121 million in total shared savings in 2013, with a net shared savings of $99 million

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These leaders from Henry Ford Health System and UCSF Medical Center are among five reappointed commissioners, one new commissioner, and new Chair Francis “Jay” Crosson, announced by GAO.

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The Energy and Commerce Committee is scheduled to vote on 21st Century Cures Wednesday, possibly including an amendment that would make changes to the 340B Drug Pricing Program.

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Calls for HHS to establish specific criteria for approval, document how programs will address the health of low-income populations, and ensure federal funding is not duplicated.

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May 29 webinar will focus on quality reporting program proposals, impact of changes to HAC Reduction Program and Hospital Readmissions Reduction Program.

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GAO found that CMS lacks adequate data to conduct provider-level oversight of Medicaid payments to ensure payments are used for Medicaid patients in an economical and efficient manner.

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The study found that 5 percent of Medicaid-only enrollees consistently accounted for almost half of the total expenditures.

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The model saved $384 million over a two-year time period and is the first alternative payment pilot to meet criteria for expansion to additional sites.

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In an April 28 letter, the association urged CMS to adopt a holistic view of how payment mechanisms impact essential hospitals, including sustainable base payment rates, Medicaid waivers to address uncompensated care, and DSRIP waivers.

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CMS suggested changes to the Medicare and Medicaid EHR Incentive Programs for 2015 through 2017 reporting, including reporting on a calendar year schedule, 90 day reporting periods, and uniform meaningful use objectives in 2015.

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The final policy takes into account changes to Medicare DSH payments, improving the accuracy of payments to hospitals.

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The Supreme Court released its 5-4 decision in Armstrong v. Exceptional Child.

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Due to Senate consideration of a bill that would extend the delay until October, CMS extends its delay through April 30.

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Today, the U.S. Supreme Court released its opinion on Armstrong v. Exceptional Child. The court ruled that Medicaid providers cannot sue states for low payment rates and advised on alternative actions.

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Learn more about association and member efforts to defend the 340B Drug Pricing Program

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The Network will support the transition toward alternative payment models, using efforts in the Medicare Program as a guide.

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Specifically, HHS will evaluate financial assistance programs, Medicaid expansion, pioneer ACOs, and marketplace payment systems.

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A new tool from the University of Chicago aims to help physicians assess and help patients facing financial burdens after a cancer diagnosis.

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Feb. 20 final rule and letter to issuers outline benefit and payment parameters for 2016 health insurance marketplace plans

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Payment methodology, to start Jan. 1, is largely unchanged from 2015

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The Oncology Care Model is a multipayer payment and care delivery model designed to encourage high quality cancer care.

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Community Health Systems (CHS) and three of its affiliated New Mexico hospitals have settled the federal False Claims Act (FCA) case, United States ex rel. Baker v. Community Health Systems Professional Services Corporation, et al. Per the settlement, CHS and the three hospitals agreed to pay the federal government $75 million. The case was initiated by a

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Justices weigh arguments for allowing providers to sue states over low payment rates - and I was there

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The six new members will serve three-year appointments, effective Jan. 1.

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Multiple exceptions are proposed to the fraud and abuse regulations that govern Medicare and Medicaid, including changes to the definition of "remuneration" in the CMP regulations and codification of the gainsharing CMP.

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Though the payment bump has reportedly increased access to care in some states, it appears unlikely that this ACA provision will be extended beyond 2014.

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What impact has section 1202 of the Affordable Care Act, also know as the primary care bump, had on your hospital?

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Hear members of our policy team discuss the association's recently released brief on innovative alternative payment models. These models focus on ways to replace or augment existing fee-for-service and managed care models, while also increasing efficiency, coordination, and quality of care.

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Explore Medicaid alternative payment models, which states have increasingly used to improve health care quality and lower costs.

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Resources include a review of the latest research examining how and why Medicaid beneficiaries seek care in the ED, a scan of how individual states set payment rates and supplemental payments to hospitals, and a review of several states' approach to Medicaid payment and delivery system reform.

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Take a deep dive of our latest policy brief on waiver-based Medicaid programs, which details how essential providers work with their state and the federal government to carry out sustainable, systemic delivery system changes.

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Letters of nomination and resumes are currently being accepted for six MACPAC seats. Appointments will be effective Jan. 1, 2015. Nominations can be submitted through Sept. 5.

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The GAO study found that private payers reimburse at higher rates than Medicaid for office visits, hospital care, and emergency care. The study was conducted with data from before the temporary increases in Medicaid reimbursement, which are set to expire at the end of 2014.

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Recent journal articles curated from Health Affairs and the New England Journal of Medicine highlight payment reform programs and strategies and the impact of socioeconomic status on readmissions.

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Learn how Texas' approach to DSRIP waivers fosters partnerships and increases the focus on community needs

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GAO released a report on the integrity of Medicaid managed care programs, detailing recommendations for CMS. The report identified potential gaps and duplication of program integrity efforts and listed recommendations, including additional oversight.

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MedPAC announced that it will look into alternatives for the two-midnight rule. The potential alternative policy will clarify the inpatient payment system to clarify when a patient is considered an inpatient and alter payment mechanisms to require less observation care.

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Congress should ensure Medicaid pays at least Medicare rates for primary care until at least 2016, said 22 groups in a June 10 letter to congressional leadership.

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Providers with pending appeals on the number of Medicaid eligible days used in the calculation of the Medicaid fraction of their disproportionate patient percentage must provide supporting information and documentation to the PRRB by July 22.

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The subcommittee focused on three issues pertaining to hospital inpatient reimbursement: 1) the two-midnight rule that redefined which hospital stays qualify for inpatient reimbursement; 2) RAC reviews of hospital payment determinations; and 3) provider appeals of Medicare payment determinations.

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For inpatient admissions with dates of admission between Oct. 1, 2013, and March 31, 2015, MACs and recovery audit contractors will not conduct postpayment patient status reviews. MACs will continue to conduct prepayment probe reviews of short stays with dates of admission between Oct. 1, 2013, and March 31, 2015.

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CMS will not approve SPAs that include non-bona fide donations as a portion, or all, of the non-federal share of Medicaid payments. Payment methodologies contingent upon the receipt of a non-bona fide donation would also be grounds for disapproval of an SPA.

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Through this model, groups of health care providers and suppliers will be responsible for all care offered to a group of beneficiaries. Applications and letters of intent are due June 23 for provider and supplier groups that include a large dialysis organization and Sept. 15 for provider and supplier groups that do not include a large dialysis organization.

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CMS released the final rule with comment period regarding the new Medicare FQHC prospective payment system. The payment system could increase Medicare payments to FQHCs by as much as 32 percent.

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Moody's reported that “factors leading to the decline in performance include low rate increases from commercial payers and rate cuts from Medicare and Medicaid." Moody's also noted that an increase in high-deductible health plans played a role.

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CMS adjusts FFS claims from 2008-2012 for DSH hospitals. The adjustment accounts for changes to Medicare DSH payments and for FY 2014 uncompensated care payments.

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CMS released new data on Medicare Part B payments to more than 800,000 physicians and other health care professionals. The data set includes calendar year 2012 data on the number and type of services provided to beneficiaries, average payments to providers for services, and the provider's average charge for services.

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Starting July 1, IQR and OQR data must be submitted through the secure portal. CMS encourages hospitals to enroll in the portal and complete the identity proofing process by May 1.

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It provides information to help states prepare for the end of the transition period established in 2008. CMS specifically outlines the requirements independent auditors must follow when conducting annual DSH audits, as well as information to help states calculate uncompensated care costs.

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A recent National Quality Forum draft report discusses whether performance measures used in accountability applications, such as pay-for-performance or public reporting, should be adjusted for socioeconomic factors when determining results; share your comments.

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The bill replaces the SGR with a sensible physician payment system, ensures the continuation of health policies that help low-income patients access health care, and mandates an annual report on Medicaid DSH payments. The association notes that it would not support any methods of paying for the legislation that would "damage access to and quality of care..."

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The legislation would extend the partial enforcement delay of the two-midnight policy and require CMS to develop new criteria for inpatient stays that last fewer than two midnights. Association President and CEO Bruce Siegel, MD, MPH, said, "It's vitally important that we get this policy right so that we don't inadvertently destabilize hospitals that care for the vulnerable."

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The Centers for Medicare & Medicaid Services has made available resources to help providers prepare for and transition to International Classification of Diseases, 10th Edition (ICD-10) diagnosis and procedure codes by Oct. 1, 2014. Resources include fact sheets, frequently asked question, webinars, and an offer to participate in end-to-end testing.

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The notice contains state-specific FY 2014 DSH allotments - without the ACA-mandated reductions. America's Essential Hospitals achieved a major legislative victory with a two-year delay of the Medicaid DSH cuts. The FY 2014 Joint Budget Resolution repealed the FY 2014 Medicaid DSH cuts, and delayed the FY 2015 Medicaid DSH cuts until FY 2016.

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CMS stated that MACs must re-review all claims denials under the probe and educate process. CMS also released a new document that provides initial data collected from the inpatient hospital probe and educate reviews.

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CMS proposes to adjust FFS claims from 2008-2012 for DSH hospitals. The proposed adjustment accounts for changes to Medicare DSH payments and for FY 2014 uncompensated care payments. Comments on the proposed call letter are due March 7.

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As of Feb. 21, hospitals will not receive new RAC ADRs until the next round of contracts are awarded. In addition, CMS announced five changes to the RAC program that will take effect under new RAC contracts. CMS has not announced when it plans to finalize new contracts.

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The OIG and HHS FY 2014 work plan includes several Medicare and Medicaid projects. These projects cover the following topics including inpatient admission criteria, E&M payments, IME, and provider taxes.

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Starting July 1, IQR and OQR data must be submitted through the secure portal. CMS encourages hospitals to enroll in the Secure Portal and complete the identity proofing process by May 1.

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CMS seeks input on models for specific procedures and complex care. These new payment and service delivery models would apply to specialty practitioner services provided in an outpatient setting.

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CMS will discuss inpatient hospital admission and medical review criteria and answer questions. A partial delay of the policy was instituted Nov. 5, 2013, and extended Jan. 31. Now recovery audit contractors and Medicare administrative contractors will not conduct postpayment patient status reviews for inpatient admissions with dates of service between Oct. 1, 2013 and Sept. 30, 2014.

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Lawmakers in both the House and Senate introduced a consensus bill to repeal the Medicare physician payment system. Reps. Frank Pallone (D-NJ) and Anna Eshoo (D-CA) have each begun campaigning to take over Henry Waxman’s (D-CA) role as ranking member on the House Energy and Commerce Committee. The House Energy and Commerce Health Subcommittee held a hearing to examine drug shortages.

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CMS posted further guidance extending the partial delay of the two-midnight policy for inpatient admission and medical review through Sept. 30. For inpatient admissions with dates of service between Oct. 1, 2013 and Sept. 30, 2014, recovery audit contractors and Medicare administrative contractors will not conduct postpayment patient status reviews.

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Voted unanimously to recommend Congress increase Medicare payments rates for FY 2015 OPPS

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Subcommittee considered necessity, effectiveness of temporary extenders

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A review of medical necessity regulations and examples of related guidelines

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Budget bill eliminates FY 2014 Medicaid DSH cuts, delays FY 2015 cuts

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House votes to restore some DSH funding. SGR bill directs HHS to monitor DSH need

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Senate Finance Committee marks up legislation to repeal the sustainable growth rate

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Congress’ top concern was possible budget agreement

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The rule reduces Medicare rates by 20.1 percent

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Rule finalizes several Outpatient Prospective Payment System provisions

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The budget committee continued work on an agreement

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Key staff indicated total cost of all extenders could be more than $200 billion

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OPPS is used by CMS for hospital outpatient services under Medicare

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The VBP program links Medicare inpatient payments to quality measure performance

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The final rule implements the Affordable Care Act's primary care payment bump

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The rule outlines reporting and cost parameters for states and individual hospitals

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Expressed concern that several provisions could challenge the ability of FQHCs to integrate care and address patient needs

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Association urged committees to ensure payment system solution does not come at the expense of hospitals

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America's Essential Hospitals cautions against paying for SGR provision with cuts to hospitals

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CMS updates earlier guidance, CCIIO addresses third-party payments of premiums for individuals covered by QHPs

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Senate Democrats pressured Obama administration to fix healthcare.gov, SGR agreement gained support

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Government shutdown prevented DC from making payments to Medicaid providers, managed care organizations

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Office urges action to ensure contractors identify, report improper payments and potential fraud

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Report evaluates differences among four types of postpayment review contractors CMS uses

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Hospital inpatient quality reporting program intended to provide consumers with quality of care information

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ACA hearings focus on health insurance exchange implementation and employer mandate delay

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Document explores care delivery and payment models that help states care for challenging patients

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Senate to consider changing existing rule requiring a filibuster-proof 60 votes for executive nominations

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House Republican leaders to meet July 10 to discuss whether to take steps toward immigration bill

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Agency accepts applications for Model 1 bundled payment initiative

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Calculation will determine reduction to each state's DSH allotment for FYs 2014 and 2015

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Plan outlines options for states to adopt delivery system reforms

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Letter to state Medicaid directors details federal-state efforts to strengthen program integrity

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Most health care spending outside of Medicare and Medicaid was subject to cuts

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Association develops entitlement reform principles to guide possible future discussions around changes to the Medicare and Medicaid programs.

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About America’s Essential Hospitals

America’s Essential Hospitals is the leading association and champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. Since 1981, America’s Essential Hospitals has initiated, advanced, and preserved programs and policies that help these hospitals ensure access to care. We support members with advocacy, policy development, research, and education.