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Recent GAO Study Finds CMS Should Improve Accessibility and Reliability of Expenditure Data

Policy Snapshot
Skilled Nursing Care, Centers for Medicare and Medicaid (CMS)
October 14, 2016
Last week, the Government Accountability Office (GAO) publicly released their report on skilled nursing facilities (SNF) where they were asked to provide information on how SNFs spend their Medicare and other revenues. GAO examined the extent to...

New Data to Increase Transparency on Medicare Hospice Payments

Policy Snapshot
Hospice, Centers for Medicare and Medicaid (CMS)
October 14, 2016
On October 6, the Centers for Medicare & Medicaid Services (CMS) released a privacy-protected public data set, the Hospice Utilization and Payment Public Use File (Hospice PUF), which provides information on services provided to Medicare...

Society Comments on CMS Episode Payment Model Proposed Rule

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Payment, Practitioners
October 7, 2016
This week, AMDA – The Society for Post-Acute and Long-Term Care Medicine submitted comments to the Centers for Medicare & Medicaid Services (CMS) on their Proposed Rule for Medicare entitled Advancing Care Coordination Through Episode Payment...

CMS Awards $347 Million to Continue Progress toward a Safer Health Care System

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Quality
October 7, 2016
The Centers for Medicare & Medicaid Services (CMS) awarded $347 million to 16 national, regional, or state hospital associations, Quality Improvement Organizations, and health system organizations to continue efforts in reducing hospital-...

New Electronic Appeals System: MOD E-File Available

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Medicare
October 7, 2016
The Medicare Operations Division Electronic Filing System (MOD E-File), launched on October 1, 2016, allowing appellants to file electronic requests for review with the Medicare Appeals Council. Appellants, parties, and the public can also use MOD E...

Billing for Influenza: New CPT Code 90674

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Influenza, Payment, Current Procedural Terminology (CPT) codes
October 7, 2016
The American Medical Association issued a new Current Procedural Terminology (CPT) code for influenza vaccine Flucelvax, CPT 90674, effective August 1, 2016 for Medicare claims. However, Medicare claims processing systems will not be able to accept...

Federal Policy Brief

Policy Snapshot
Advance Care Planning, Practitioners, Quality
October 7, 2016
Last week, the House and Senate passed a continuing resolution to keep the federal government funded at current levels through December 9. President Obama signed the legislation, averting a government shutdown. Both chambers are now in recess...

CMS Releases Final Conditions of Participation Rule for Long-Term Care Facilities

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Federal Regulations, F-Tags
September 30, 2016
This week the Centers for Medicare & Medicaid Services (CMS) issued a final rule to make major changes to improve the care and safety of the nearly 1.5 million residents in the more than 15,000 long-term care facilities that participate in the...

CMS Hosts SNF Value-Based Purchasing Open Door Forum

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Payment
September 30, 2016
This week the Centers for Medicare & Medicaid Services (CMS) hosted an Open Door Forum to provide details about the Skilled Nursing Facility (SNF) Value-Based Purchasing Program (VBP). The program enacted under the Protecting Access to Medicare...

2015 PQRS Feedback Reports and 2015 Annual QRURs Available

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Payment, Physician Quality Reporting System (PQRS)
September 30, 2016
2015 Physician Quality Reporting System (PQRS) Feedback Reports and 2015 Annual Quality and Resource Use Reports (QRURs) are available. The PQRS Feedback Reports show your program year 2015 PQRS reporting results, including payment adjustment...