11/06/2018

CMS-Medicare

Recent Oncology Related Articles

Groups to Sue CMS Over Site-Neutral Payments

(Medscape Medical News) Nov 5, 2018 - The American Society of Clinical Oncology (ASCO) has indicated its extreme dislike of the site-neutral policy. In September comments on the proposed rule, ASCO urged the agency not to employ the payment scheme. READ ARTICLE (free registration required)

Final Rules from CMS Offer Something for Everyone

The Centers for Medicare & Medicaid Services (CMS) has been quite busy these last few weeks, getting approval for and publishing a number of critical final rules that will have an impact on documentation, coding, and payments.    A number of the rules had to do with ways to reduce the prices of drugs and to make changes to the insurance programs operating under the Patient Protection and Affordable Care Act (PPACA). The key topics for our audience were the final rules for the 2019 Medicare Physician Fee Schedule (MPFS) and Quality Payment Program (QPP), the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment Policy, and the Home Health Prospective Payment System (PPS) System Update. READ MORE

Physician Fee Schedule Final Rule: Understanding 3 Key Topics Call — November 19
Monday, November 19 from 2 to 3:30 pm ET

Register for Medicare Learning Network events.

The CY 2019 Physician Fee Schedule final rule is estimated to increase the amount of time doctors and other clinicians spend with their patients by reducing the burden of Medicare paperwork. During this call, CMS experts briefly cover three provisions and address your questions:

• Streamlining Evaluation and Management (E/M) payment and reducing clinician burden
• Advancing virtual care
• Continuing to improve the Quality Payment Program to reduce burden and offer flexibilities to help clinicians successfully participate
  

MRI MLN Matters Article — New

A new MLN Matters Article MM10877 on Magnetic Resonance Imaging (MRI) is available. Learn about
allowable line items.

Patient Relationship Categories and Codes Webcast: Audio Recording and Transcript — New

An audio recording and transcript are available for the October 17 webcast on Patient Relationship Categories and Codes. Receive guidance for classifying patient relationships during the voluntary reporting period that CMS implemented on January 1, 2018. 

Medicare and Medicaid Basics Booklet — Revised

A revised Medicare and Medicaid Basics Booklet is available. Learn quick facts, covered services, and other types of common coverage.

Quality Payment Program 2018 MIPS Cost Performance Category Web-Based Training Course — New

With Continuing Education Credit

A new Quality Payment Program in 2018: Merit-based Incentive Payment System (MIPS) Cost Performance Category Web-Based Training Course is available through the Learning Management System. Learn about:

• Data sources used to calculate scores
• Cost score calculation methods
• Beneficiary attribution

Quality Payment Program 2018 MIPS Improvement Activities Performance Category Web-Based Training Course — Revised

With Continuing Education Credit

A revised Quality Payment Program in 2018: Merit-based Incentive Payment System (MIPS) Improvement Activities Performance Category Web-Based Training Course is available through the Learning Management System. Learn about:

• Requirements
• How the category fits in the Quality Payment Program
• Steps to report data
• Basics of scoring

Quality Payment Program 2018 MIPS APMs Web-Based Training Course — Revised

With Continuing Education Credit

A revised Quality Payment Program in 2018: Merit-based Incentive Payment System (MIPS) Alternative Payment Models (APMs) Web-Based Training Course is available through the Learning Management System. Learn:

• How to recognize if you are a part of a MIPS APM
• Benefits of the special APM scoring standard
• Criteria for reporting on performance

Quality Payment Program 2018 Advanced APMs Web-Based Training Course — Revised

With Continuing Education Credit

A revised Quality Payment Program in 2018: Advanced Alternative Payment Models (APMs) Web-Based Training Course is available through the Learning Management System. Learn:

• How to identify Advanced APMs
• How to participate in QPP via an Advanced APM

CMS announces 2019 Medicare Parts A & B premiums and deductibles

On October 12, 2018, the Centers for Medicare & Medicaid Services (CMS) released the 2019 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs.  The standard monthly premium for Medicare Part B enrollees will be $135.50 for 2019, a slight increase from $134 in 2018. READ MORE

LCDs MLN Matters Article — New

A new MLN Matters Article MM10901 on Local Coverage Determinations (LCDs) is available. Learn about detailed changes to the LCD process.

Updates to the OCM Quality Measures and Lessons Learned Moving Forward

(Journal Of Clinical Pathways) Oct 28, 2018 - Andrew York, PharmD, JD, Center for Medicare and Medicaid Innovation (CMMI), Centers for Medicare and Medicaid Services (CMS), provided an update on the role of quality improvement in oncology value-based payment, with specific attention to Oncology Care Model (OCM) Quality Measures. READ ARTICLE

Recent LearnResource & MedLearn Matters Articles

• January 2019 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files (MM 11016)
• Magnetic Resonance Imaging (MRI) (MM 10877)