Washington Update. Rebecca Hyder Director, Congressional Affairs American Academy of Ophthalmology

Save this PDF as:

Size: px
Start display at page:

Download "Washington Update. Rebecca Hyder Director, Congressional Affairs American Academy of Ophthalmology"

Transcription

1 Washington Update Rebecca Hyder Director, Congressional Affairs American Academy of Ophthalmology

2 214 Legislative Agenda Medicare Physician Payment Reform Compounding Vision Research Funding

3 Physician Payment Environment Physicians face a 24 cut starting April 1 due to the sustainable growth rate (SGR) formula which is used to determine Medicare payments Over last 1 years, Congress has spent nearly $154 billion to avert SGR cuts to doctors Conservatives in House insist on offsets for patches Harder to find offsets to pay for short-term patches Other providers lobbying to avoid being a pay-for for SGR patch 2% cuts to Medicare services payments under budget sequestration has been extended to 223

4 Physician Payment Environment Physicians face increasing penalties under existing Medicare quality improvement programs (PQRS, EHR/MU and VBM) Ophthalmology also targeted under potentially misvalued codes initiative Without Reform, Cuts in Medicare Fee-for-Service is the Future

5 Value Based Purchasing VBP PQRS (Successful Participation) (Not Participating) MOC (Participate) CMS may consider MOC in the value based modifier. E RX (Successful Participation) (Not Successful) EHR (Achieve MU) Beginning in 211, physicians can earn up to $44, for adoption of EHR/MU (Qualifying for EHR MU precludes e- prescribing bonus) (Not Achieving) to -5 VBM (based on PQRS participation) -1 to +2x (groups of 1+) TBD proposed -2 +1x 2x TBD (all physicians) potentially -3 TBD potentially -3 or more Total Exposure 4%** 4% 2.5% +2% to -1% * * +1.5% to -1.5% * -2% +1% to -2% * -3.5% to +2x potentially -6% potentially -8 or more potentially -8 to 1

6 Physician Payment Reform CBO Score $116 Billion- SGR Repeal on Sale More Agreement on What Should Replace the SGR Policymakers Want to Incentivize Physicians to Move to New Payment Models

7 Physician Payment Reform Three Committees of Jurisdiction Senate Finance House Ways and Means House Energy and Commerce Committees Approved SGR Bills in 213 Committees Reached Agreement on Final SGR Bill Last Week

8 Physician Payment Reform H.R. 415/S. 2 Bipartisan, Bicameral Support Repeal SGR Preserve a Fee-for-Service Payment Model Provide 5-years of Stable Payments with.5% Positive Updates Provide Financial Incentives to Transition to APM Provide Penalty Relief from Existing Quality Programs

9 Physician Payment Reform New Merit-Based Incentive Payment System (MIPS) includes PQRS, EHR/MU, VBM and new clinical practice improvement activities Starts in 218 High Performers Eligible for Incentive Payments Low Performers Face Penalties Capped at 4% in First Year Forces Redistribution of Dollars Among Specialties and Primary Care

10 Physician Payment Reform Finding Offsets Remains a Challenge to Moving Forward Funding Discussions are Ongoing Outcome Depends on Medicine Reaction-Engagement

11 Compounding October 212 fungal meningitis outbreak Traced to epidural steroid injections from New England Compounding Center 64 deaths, 751 sickened nationwide Increased scrutiny of compounding pharmacies on state and federal level

12 Compounding Ophthalmology: Every subspecialty uses compounded drugs Retina, Glaucoma, Cornea, Pediatrics Access to drugs for office critical to practice of ophthalmology Want safe and effective treatments for patients Worked across ophthalmology and the rest of medicine at both state and federal level to ensure access

13 Compounding Public Law : Repackaging of drugs, like Avastin, regulated under existing law; FDA enforcement discretion Outsourcing facilities that voluntarily register for FDA oversight and meet higher federal safety standards can compound large volume for office use Traditional compounding preserved and operates under current law As FDA implements the new law, AAO is working to ensure access to compounded and repacked drugs through the regulatory process

14 Vision Research Funding In the FY214 omnibus appropriations bill, NEI received $682 million, a 3 percent increase over federal FY213. While a positive development, this is still $19 million less than funding levels in place before the across-the-board cuts in federal spending caused by sequestration. The Defense Vision Trauma Research Program received $1 million in FY213 and FY214. The VTRP focuses on combat-related vision research and is the only dedicated funding source for extramural vision research into immediate battlefield needs.

Overview of Physician Payment System Reforms in the Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2)

Overview of Physician Payment System Reforms in the Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2) Overview of Physician Payment System Reforms in the Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2) June 18, 2015 Prepared for The Health Collaborative akingump.com 2015 Akin Gump Strauss

More information

SGR Repeal: What Are the Implications to Academic Medicine? Len Marquez Mary Wheatley April 17, 2015

SGR Repeal: What Are the Implications to Academic Medicine? Len Marquez Mary Wheatley April 17, 2015 SGR Repeal: What Are the Implications to Academic Medicine? Len Marquez Mary Wheatley April 17, 2015 Agenda SGR Eulogy High Level Issues in HR2 Important to Academic Medicine Overview of the SGR Replacement

More information

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Summary of SGR Repeal and Replacement Provisions

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Summary of SGR Repeal and Replacement Provisions ACOG Government Affairs May 2015 The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Summary of SGR Repeal and Replacement Provisions This landmark bipartisan legislation, signed into law

More information

Repeal the Sustainable Growth Rate (SGR), avoiding annual double digit payment cuts;

Repeal the Sustainable Growth Rate (SGR), avoiding annual double digit payment cuts; Background Summary of H.R. 2: The Medicare Access and CHIP Reauthorization Act of 2015 SGR Reform Law Enacts Payment Reforms to Improve Quality, Outcomes, and Cost On April 16, 2015, the President signed

More information

The Sustainable Growth Rate (SGR) and Medicare Physician Payments: Frequently Asked Questions

The Sustainable Growth Rate (SGR) and Medicare Physician Payments: Frequently Asked Questions The Sustainable Growth Rate (SGR) and Medicare Physician Payments: Frequently Asked Questions Jim Hahn Specialist in Health Care Financing March 21, 2014 Congressional Research Service 7-5700 www.crs.gov

More information

Medicare Access and CHIP Reauthorization Act of 2015 H.R. 2

Medicare Access and CHIP Reauthorization Act of 2015 H.R. 2 Medicare Access and CHIP Reauthorization Act of 2015 H.R. 2 The American Medical Association and over 750 national and state-based physician and specialty organizations have gone on record in support of

More information

February 10, 2014. The Honorable Nancy Pelosi Minority Leader U.S. House of Representatives H-204 U.S. Capitol Building Washington, DC 20515

February 10, 2014. The Honorable Nancy Pelosi Minority Leader U.S. House of Representatives H-204 U.S. Capitol Building Washington, DC 20515 February 10, 2014 The Honorable John A. Boehner Speaker U.S. House of Representatives H-232 U.S. Capitol Building Washington, DC 20515 The Honorable Nancy Pelosi Minority Leader U.S. House of Representatives

More information

Crosswalk of the Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2) April 21, 2015

Crosswalk of the Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2) April 21, 2015 Crosswalk of the Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2) April 21, 2015 ACP has developed a cross-walk analysis of legislation in the 114 th Congress to permanently repeal Medicare

More information

CMS Listening Session: EHR Incentive Programs in 2018 & Beyond

CMS Listening Session: EHR Incentive Programs in 2018 & Beyond CMS Listening Session: EHR Incentive Programs in 2018 & Beyond Kate Goodrich, MD, MHS, Director, Center for Clinical Standards and Quality Robert Anthony, Deputy Director, Quality Measurement & Value-Based

More information

Section by Section Summary of The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013

Section by Section Summary of The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 Section by Section Summary of The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 Title I Medicare Payment for Physicians Services Section 101. Short Title; Table of Contents. Section

More information

Sustainable Growth Rate (SGR) Repeal and Replace: Comparison of 2014 and 2015 Legislation

Sustainable Growth Rate (SGR) Repeal and Replace: Comparison of 2014 and 2015 Legislation Sustainable Growth Rate (SGR) Repeal and Replace: Comparison of 2014 and 2015 Legislation Proposal 113 th Congress - - H.R.4015/S.2000 114 th Congress - - H.R.1470 SGR Repeal and Annual Updates General

More information

The ABCs of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

The ABCs of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) The ABCs of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Medicare Access and CHIP Reauthorization Act (MACRA) Repeals the Sustainable Growth Rate Moves to a payment system based on

More information

American College of Osteopathic Internists 2015 Annual Convention and Scientific Sessions Tampa, FL October 3, 2015

American College of Osteopathic Internists 2015 Annual Convention and Scientific Sessions Tampa, FL October 3, 2015 American College of Osteopathic Internists 2015 Annual Convention and Scientific Sessions Tampa, FL October 3, 2015 Timothy W. McNichol, Esq. Deputy Executive Director Medicare Physician Reimbursement

More information

PAs and Provisions of Health. What does it Mean to You?

PAs and Provisions of Health. What does it Mean to You? PAs and Provisions of Health Reform What does it Mean to You? Presentation to the South Dakota Academy of Physician Assistants March 7, 2013 Liz Roe, Director, Constituent t Organization Outreach and Advocacy

More information

U.S. House of Representatives Committee on Energy and Commerce Subcommittee on Health. A Permanent Solution to the SGR: The Time Is Now

U.S. House of Representatives Committee on Energy and Commerce Subcommittee on Health. A Permanent Solution to the SGR: The Time Is Now U.S. House of Representatives Committee on Energy and Commerce Subcommittee on Health A Permanent Solution to the SGR: The Time Is Now January 21 & 22, 2015 Submitted Testimony regarding Standards of Care

More information

A BIPARTISAN PLAN TO REDUCE OUR NATION S DEFICITS EXECUTIVE SUMMARY

A BIPARTISAN PLAN TO REDUCE OUR NATION S DEFICITS EXECUTIVE SUMMARY A BIPARTISAN PLAN TO REDUCE OUR NATION S DEFICITS EXECUTIVE SUMMARY This bipartisan, comprehensive, and balanced plan consistent with the recommendations of the Bowles-Simpson fiscal commission that will:

More information

o The bipartisan Joint Committee on Taxation says that eliminating the tax would reduce family premiums. 2

o The bipartisan Joint Committee on Taxation says that eliminating the tax would reduce family premiums. 2 The Health Insurance Tax Will Hurt. The new health insurance tax will increase the cost of health care benefits, harming those who need help the most: small businesses, families who work for a small business

More information

January 22, 2015. Thank you Chairman Pitts, Ranking Member Green, and members of the Committee. I

January 22, 2015. Thank you Chairman Pitts, Ranking Member Green, and members of the Committee. I STATEMENT Of Kenneth P. Miller, PhD, RN, CFNP, FAAN, FAANP To United States House of Representatives Committee on Energy & Commerce Subcommittee on Health On A Permanent Solution to the SGR: The Time is

More information

5/19/2016 MIPS AND MACRA: MAKING SENSE OF THE NEW REGULATIONS AND PAYMENT SYSTEMS. No Disclosures AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS

5/19/2016 MIPS AND MACRA: MAKING SENSE OF THE NEW REGULATIONS AND PAYMENT SYSTEMS. No Disclosures AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS MIPS AND MACRA: MAKING SENSE OF THE NEW REGULATIONS AND PAYMENT SYSTEMS 1 No Disclosures 2 1 To Better Understand the Future.. We must remember the past regarding physician payment. 3 THE SGR SGR=Sustainable

More information

HIMSS Public Policy Initiatives in 2015: Using Health IT to Enable Healthcare Transformation Jeff Coughlin Senior Director Federal & State Affairs

HIMSS Public Policy Initiatives in 2015: Using Health IT to Enable Healthcare Transformation Jeff Coughlin Senior Director Federal & State Affairs HIMSS Public Policy Initiatives in 2015: Using Health IT to Enable Healthcare Transformation Jeff Coughlin Senior Director Federal & State Affairs March 26, 2015 Agenda Meaningful Use Stage 3 NPRM 2015

More information

US Medicare Accountable Care Organizations (ACOs)

US Medicare Accountable Care Organizations (ACOs) James H Thrall MD Chairman Emeritus, Department of Radiology Massachusetts General Hospital Distinguished Juan M Taveras Professor of Radiology Harvard Medical School US Medicare Accountable Care Organizations

More information

The Changing Health Care Delivery and Payment Landscape from a Policy Perspective

The Changing Health Care Delivery and Payment Landscape from a Policy Perspective The Changing Health Care Delivery and Payment Landscape from a Policy Perspective Presented by: Camille S. Bonta, MHS Summit Health Care Consulting April 19, 2016 Health Care Spending is Rising National

More information

CMS QCDR (Qualified Clinical Data Registry) and Other Ways PPRNet Can Help with Value-Based Payment

CMS QCDR (Qualified Clinical Data Registry) and Other Ways PPRNet Can Help with Value-Based Payment CMS QCDR (Qualified Clinical Data Registry) and Other Ways PPRNet Can Help with Value-Based Payment Cara Litvin MD, MS Assistant Professor MUSC Department of Medicine Agenda Provide an update of the current

More information

Health Care Economics and Audiology: Why are WE Feeling the Pain? Disclosures. Disclosure 1/6/2016

Health Care Economics and Audiology: Why are WE Feeling the Pain? Disclosures. Disclosure 1/6/2016 Health Care Economics and Audiology: Why are WE Feeling the Pain? Robert Fifer, Ph.D. University of Miami Miller School of Medicine Mailman Center for Child Development Disclosures Employed by the University

More information

Meaningful Use Updates. HIT Summit September 19, 2015

Meaningful Use Updates. HIT Summit September 19, 2015 Meaningful Use Updates HIT Summit September 19, 2015 Meaningful Use Updates Nadine Owen, BS,CHTS-IS, CHTS-IM Health IT Analyst Hawaii Health Information Exchange No other relevant financial disclosures.

More information

Summary of Federal SCHIP Reauthorization, Economic Stimulus, and Health Care Reform Bills and Proposals

Summary of Federal SCHIP Reauthorization, Economic Stimulus, and Health Care Reform Bills and Proposals Summary of Federal SCHIP Reauthorization, Economic Stimulus, and Health Care Reform Bills and Proposals I. Children s Health Insurance Program (CHIP) Reauthorization Act of 2009 A. Funding for CHIP. The

More information

Overview of the EHR Incentive Programs and Merit-Based Incentive Payment System

Overview of the EHR Incentive Programs and Merit-Based Incentive Payment System Overview of the EHR Incentive Programs and Merit-Based Incentive Payment System Patrick M. Hamilton, MPA Health Insurance Specialist/Rural Health Coordinator Centers for Medicare & Medicaid Services Philadelphia

More information

The SGR Fix: A Pathway to Fundamental Physician Payment Reform?

The SGR Fix: A Pathway to Fundamental Physician Payment Reform? The SGR Fix: A Pathway to Fundamental Physician Payment Reform? Center on Health Care Effectiveness Mathematica Policy Research Washington, DC March 11, 2015 Moderator Eugene Rich Director, Center on Health

More information

CMS is requesting information to aid in the planning and implementation of the MIPS in the following areas:

CMS is requesting information to aid in the planning and implementation of the MIPS in the following areas: Summary of Medicare s Request for Information on the Provisions in MACRA which Allow for Implementation of Alternative Payment Models and a Merit-Based Incentive Payment System On September 28, 2015, the

More information

December 21, 2012. The Honorable Harry Reid Majority Leader U.S. Senate S-221 U.S. Capitol Washington, DC 20510

December 21, 2012. The Honorable Harry Reid Majority Leader U.S. Senate S-221 U.S. Capitol Washington, DC 20510 December 21, 2012 The Honorable Harry Reid Majority Leader U.S. Senate S-221 U.S. Capitol Washington, DC 20510 The Honorable Mitch McConnell Republican Leader U.S. Senate S-230 U.S. Capitol Washington,

More information

Health Reform and the AAP: What the New Law Means for Children and Pediatricians

Health Reform and the AAP: What the New Law Means for Children and Pediatricians Health Reform and the AAP: What the New Law Means for Children and Pediatricians Throughout the health reform process, the American Academy of Pediatrics has focused on three fundamental priorities for

More information

Statement Of. The National Association of Chain Drug Stores. For. U.S. Senate Special Committee on Aging. Hearing on:

Statement Of. The National Association of Chain Drug Stores. For. U.S. Senate Special Committee on Aging. Hearing on: Statement Of The National Association of Chain Drug Stores For U.S. Senate Special Committee on Aging Hearing on: 10 Years Later: A Look at the Medicare Prescription Drug Program 2:30 p.m. 366 Dirksen

More information

Issue Summary: Medicare Physician Payment

Issue Summary: Medicare Physician Payment Issue Summary: Medicare Physician Payment The current Medicare physician payment system, especially the sustainable growth rate (SGR), is characterized by instability, inequity and a failure to account

More information

ADVOCACY UPDATE July 14, 2011

ADVOCACY UPDATE July 14, 2011 ADVOCACY UPDATE July 14, 2011 2012 Medicare physician payment proposed rule On July 1, the Centers for Medicare and Medicaid Services (CMS) published a proposed regulation detailing Medicare physician

More information

The American Tax Relief Act of 2012 Summary of Health Care Related Provisions January 2013

The American Tax Relief Act of 2012 Summary of Health Care Related Provisions January 2013 of 2012 Summary of Health Care Related Provisions On January 3, President Obama signed the American Tax Relief Act of 2012 (ATRA) to partially avert the so-called fiscal cliff, which would have resulted

More information

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), H.R. 2, Pub. Law 114-10

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), H.R. 2, Pub. Law 114-10 Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), H.R. 2, Pub. Law 114-10 AMA section-by-section summary H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015 or MACRA, was passed

More information

SGR Repeal and Medicare Provider Payment Modernization Act of 2015: Timeline of Implementation

SGR Repeal and Medicare Provider Payment Modernization Act of 2015: Timeline of Implementation SGR Repeal and Medicare Provider Payment Modernization Act of 2015: Timeline of Implementation 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026+ Base Update Jan Jun: 0 July- Dec: 0.5 0.5% 0.5%

More information

May 8, 2013. The Honorable Fred Upton Chairman House Committee on Energy and Commerce United States House of Representatives Washington, DC 20151

May 8, 2013. The Honorable Fred Upton Chairman House Committee on Energy and Commerce United States House of Representatives Washington, DC 20151 May 8, 2013 The Honorable Dave Camp Chairman House Committee on Ways and Means United States House of Representatives Washington D.C. 20515 The Honorable Fred Upton Chairman House Committee on Energy and

More information

The Impact of Changing Federal Policies on Physician Reimbursement

The Impact of Changing Federal Policies on Physician Reimbursement The Impact of Changing Federal Policies on Physician Reimbursement Peter Margolis, MD, AGAF Chair elect, AGA Regulatory Work Group AGA Institute Practice Management & Economics Committee University Gastroenterology

More information

(http://www.regulations.gov/#!documentdetail;d=cms-2013-0155-10181) File # CMS-2013-0155-10181

(http://www.regulations.gov/#!documentdetail;d=cms-2013-0155-10181) File # CMS-2013-0155-10181 January 27, 2014 Marilyn Tavenner, Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-4159-P P.O. Box 8013 Baltimore, MD 21244-8013 Re: Final

More information

Transforming Healthcare through Data-Driven Solutions. Pay for Performance Solutions

Transforming Healthcare through Data-Driven Solutions. Pay for Performance Solutions Transforming Healthcare through Data-Driven Solutions Pay for Performance Solutions Medicare Access and CHIP Reauthorization Act of 2015 MACRA Enacted April 15, 2015 10/14/2015 Copyright Mingle Analytics

More information

ACG 2014 Annual Postgraduate Course Copyright 2014 American College of Gastroenterology 1

ACG 2014 Annual Postgraduate Course Copyright 2014 American College of Gastroenterology 1 Healthcare Reform and the Gastroenterologist: The Future of our Profession Harry Sarles Jr., MD, FACG PREPARATION TAKE YOUR FAVORITE PPI MIX WITH YOUR FAVORITE H2 BLOCKER AND ANTACID SWALLOW REPEAT PRN

More information

Waste and inefficiency in the Bush Medicare prescription drug plan: Allowing Medicare to negotiate lower prices could save $30 billion a year

Waste and inefficiency in the Bush Medicare prescription drug plan: Allowing Medicare to negotiate lower prices could save $30 billion a year Waste and inefficiency in the Bush Medicare prescription drug plan: Allowing Medicare to negotiate lower prices could save $30 billion a year By Roger Hickey & Jeff Cruz In cooperation with Dean Baker,

More information

DENVER MEDICAL BULLETIN

DENVER MEDICAL BULLETIN DENVER MEDICAL BULLETIN Official Publication of The Denver Medical Society Volume 101/Number 9 September 2011 Joint Congressional Committee Will Influence Future of Medicine Actions Over Next Four Months

More information

COMPOUNDED DRUGS UNDER MEDICARE PART B: PAYMENT AND OVERSIGHT

COMPOUNDED DRUGS UNDER MEDICARE PART B: PAYMENT AND OVERSIGHT Department of Health and Human Services OFFICE OF INSPECTOR GENERAL COMPOUNDED DRUGS UNDER MEDICARE PART B: PAYMENT AND OVERSIGHT Daniel R. Levinson Inspector General April 2014 OEI-03-13-00270 EXECUTIVE

More information

Adapting cardiology practice to recent and future health care legislation. David May MD, PhD FACC

Adapting cardiology practice to recent and future health care legislation. David May MD, PhD FACC Adapting cardiology practice to recent and future health care legislation David May MD, PhD FACC Disclosure Chairman, ACC Board of Governors Served on a number of ACC committees (pro bono) Payment reform

More information

Medicare Physician Reporting: Beyond PQRS. Mary Patton Wheatley Senior Specialist, AAMC August 17, 2011

Medicare Physician Reporting: Beyond PQRS. Mary Patton Wheatley Senior Specialist, AAMC August 17, 2011 Medicare Physician Reporting: Beyond PQRS Mary Patton Wheatley Senior Specialist, AAMC August 17, 2011 Who is the AAMC? The Association of American Medical Colleges (AAMC) serves and leads the academic

More information

The Continued Need for Reform: Building a Sustainable Health Care System

The Continued Need for Reform: Building a Sustainable Health Care System The Continued Need for Reform: Building a Sustainable Health Care System Sustainable reform must address cost and quality, while expanding coverage through a vibrant and functional marketplace As the largest

More information

Overview of MU Stage 2 Joel White, Health IT Now

Overview of MU Stage 2 Joel White, Health IT Now Overview of MU Stage 2 Joel White, Health IT Now 1 Agenda 1. Introduction 2. Context 3. Adoption Rates of HIT 4. Overview of Stage 2 Rules 5. Overview of Issues 6. Trend in Standards: Recommendations v.

More information

The Health Care Law s Impact on the Medicare Program and its Beneficiaries

The Health Care Law s Impact on the Medicare Program and its Beneficiaries MEDIA ADVISORY February 10, 2011 Contact: David Kinsman, (202) 261 4554 dkinsman@acponline.org Jacquelyn Blaser, (202) 261 4572 jblaser@acponline.org Statement of the American College of Physicians for

More information

Medicare Electronic Health Record Incentive Payments for Eligible Professionals Last Updated: May 2013

Medicare Electronic Health Record Incentive Payments for Eligible Professionals Last Updated: May 2013 Medicare Electronic Health Record Incentive Payments for Eligible Professionals Last Updated: May 2013 The Medicare Electronic Health Record (EHR) Incentive Program provides for incentive payments to Medicare

More information

3/9/2011 ELECTRONIC HEALTH RECORDS: A NATIONAL PRIORITY. Mandate for electronic health records is tied to:

3/9/2011 ELECTRONIC HEALTH RECORDS: A NATIONAL PRIORITY. Mandate for electronic health records is tied to: To lower health care cost, cut medical errors, And improve care, we ll computerize the nation s health records in five years, saving billions of dollars in health care costs and countless lives. ELECTRONIC

More information

Meaningful Reporting From the EHR

Meaningful Reporting From the EHR Meaningful Reporting From the EHR Rebecca Lagerquist EHR Software Analyst / Trainer Delaware Health Net, Inc. April 2010 1 The Challenge In 2004 the White House set the goal that by the year 2014 most

More information

Improve the Quality of Care and Earn $12,000 A simple guide to understanding the Medicare EHR Incentive program, from registration through

Improve the Quality of Care and Earn $12,000 A simple guide to understanding the Medicare EHR Incentive program, from registration through Improve the Quality of Care and Earn $12,000 A simple guide to understanding the Medicare EHR Incentive program, from registration through attestation. Objectives How to calculate Medicare Incentives and

More information

Presentation to the Legislative Health and Human Services Committee. Julie Weinberg, Deputy Director HSD, Medical Assistance Division

Presentation to the Legislative Health and Human Services Committee. Julie Weinberg, Deputy Director HSD, Medical Assistance Division Medicaid EHR Incentive Program: Promoting the Adoption and Meaningful Use of Health Information Technology Presentation to the Legislative Health and Human Services Committee August 3, 2010 Julie Weinberg,

More information

Grantmakers of Kentucky Washington Update. August 27, 2012

Grantmakers of Kentucky Washington Update. August 27, 2012 Grantmakers of Kentucky Washington Update August 27, 2012 About Independent Sector Membership organization @IndSector Focused on federal level sector-wide issues www.facebook.com/ IndependentSector Priorities

More information

PHOTO HERE. Monarch Pioneer ACO: Designing and Implementing a Successful Shared Risk Model

PHOTO HERE. Monarch Pioneer ACO: Designing and Implementing a Successful Shared Risk Model PHOTO HERE Monarch Pioneer ACO: Designing and Implementing a Successful Shared Risk Model March 2014 Agenda About Monarch HealthCare Monarch s Pioneer ACO Experience Monarch s Evolving ACO Strategy Future

More information

MACRA & APMs: More than Acronyms June 2, 2016

MACRA & APMs: More than Acronyms June 2, 2016 MACRA & APMs: More than Acronyms June 2, 2016 Agenda 1. Framework 2. CMS Quality Initiatives 3. MACRA - MIPS or APM? 4. Alternative Payment Models 5. Case Study 2 Alternative Payment Models Transitioning

More information

SUMMARY OF HEALTH IT AND HEALTH DATA PROVISIONS OF H.R. 2, THE MEDICARE ACCESS AND CHIP REAUTHORIZATION ACT (MACRA)

SUMMARY OF HEALTH IT AND HEALTH DATA PROVISIONS OF H.R. 2, THE MEDICARE ACCESS AND CHIP REAUTHORIZATION ACT (MACRA) SUMMARY OF HEALTH IT AND HEALTH DATA PROVISIONS OF H.R. 2, THE MEDICARE ACCESS AND CHIP REAUTHORIZATION ACT (MACRA) H.R. 2, the SGR Repeal and Medicare Provider Payment Modernization Act of 2015 was introduced

More information

e-health snapshot E-Health Snapshot Shell August 2009

e-health snapshot E-Health Snapshot Shell August 2009 e-health snapshot E-Health Snapshot Shell Federal Support for Health Information Technology in Medicaid: Key Provisions in the American Recovery and Reinvestment Act August 2009 Summary The American Recovery

More information

The Impact of Value- Based Purchasing in the Healthcare Industry

The Impact of Value- Based Purchasing in the Healthcare Industry The Impact of Value- Based Purchasing in the Healthcare Industry Presented By: Kim Charland, BA, RHIT, CCS Senior Vice President Clinical Innovation for Panacea Healthcare Solutions and Editor of VBPmonitor

More information

Electronic Health Records: What it Means for Today s Radiologist By: Anne Reynolds

Electronic Health Records: What it Means for Today s Radiologist By: Anne Reynolds Electronic Health Records: What it Means for Today s Radiologist By: Anne Reynolds Introduction Program Overview In February of 2009, President Obama signed the American Recovery and Reinvestment Act of

More information

Supplier Strategies Track

Supplier Strategies Track Supplier Strategies Track Disruptions from Washington Speaker: Blair Childs, SVP, Public Affairs, Premier Today s presentation Trends in payment and health policy Policy environment and implications Payment

More information

Health System Transformation Post Affordable Care Act

Health System Transformation Post Affordable Care Act Health System Transformation Post Affordable Care Act Patrick Conway, MD, MSc Acting Principal Deputy Administrator and Chief Medical Officer, CMS Deputy Administrator for Innovation and Quality October

More information

What you need to know to realize value-based revenue

What you need to know to realize value-based revenue The Definitive Guide to Value-Based Care What you need to know to realize value-based revenue 1 Making sense of value-based care 5 How meaningful is Meaningful Use? 2 Why the change to P4P is needed 6

More information

The Road to Meaningful Use EHR Stimulus Payments. By Amy S. Leopard, Walter & Haverfield LLP

The Road to Meaningful Use EHR Stimulus Payments. By Amy S. Leopard, Walter & Haverfield LLP The Road to Meaningful Use EHR Stimulus Payments By Amy S. Leopard, Walter & Haverfield LLP On July 28, 2010, the Centers for Medicare and Medicaid Services (CMS) published a final rule regarding what

More information

MACRA: Medicare's Shift to Value-based Delivery & Payment Models. Presented by Amy Mullins, MD, CPE, FAAFP

MACRA: Medicare's Shift to Value-based Delivery & Payment Models. Presented by Amy Mullins, MD, CPE, FAAFP MACRA: Medicare's Shift to Value-based Delivery & Payment Models Presented by Amy Mullins, MD, CPE, FAAFP Current State Over Utilization Volume over Value Fee for Service Silos of Care 2 Push Toward Value

More information

Recent Developments In Healthcare

Recent Developments In Healthcare April 20, 2015 Recent Developments In Healthcare John L. Moore 2015 Williams Parker Welcome Sustainable Growth Rate Formula Sustainable Growth Rate Formula (SGR) was adopted in the Balanced Budget Act

More information

Reimbursement Outlook and Analysis

Reimbursement Outlook and Analysis HIDA Webinar Series Reimbursement Outlook and Analysis SNFs, HHAs, & IRFs Agenda Current Regulatory Landscape Skilled Nursing Facilities Home Health Agencies Independent Rehab Facilities Healthcare Reform

More information

MEDICARE PHYSICAL THERAPY. Self-Referring Providers Generally Referred More Beneficiaries but Fewer Services per Beneficiary

MEDICARE PHYSICAL THERAPY. Self-Referring Providers Generally Referred More Beneficiaries but Fewer Services per Beneficiary United States Government Accountability Office Report to Congressional Requesters April 2014 MEDICARE PHYSICAL THERAPY Self-Referring Providers Generally Referred More Beneficiaries but Fewer Services

More information

PROVIDER & FACILITY REIMUBURSEMENT FOR CERTAIN GI SERVICES. 2011 Final. 2011 Rule. 2010 Current Rate. 2011 Final Rule (HOPD) (ASC)

PROVIDER & FACILITY REIMUBURSEMENT FOR CERTAIN GI SERVICES. 2011 Final. 2011 Rule. 2010 Current Rate. 2011 Final Rule (HOPD) (ASC) This Week in Washington D.C.: 1. CMS releases final regulations on 2011 Medicare physician reimbursement and ASC payments 2. Republicans take over House in the mid-term elections Medicare Physician and

More information

CMS REGULATORY ACTION

CMS REGULATORY ACTION CMS REGULATORY ACTIONS CMS REGULATORY ACTION Government Provider Cost Limit Regulation Imposes new restrictions on payments to providers operated by units of government and clarifies that those entities

More information

June 18, 2015. 219 Dirksen Senate Building 221 Dirksen Senate Building Washington, D.C. 20510 Washington, D.C. 20510

June 18, 2015. 219 Dirksen Senate Building 221 Dirksen Senate Building Washington, D.C. 20510 Washington, D.C. 20510 June 18, 2015 The Honorable Orrin Hatch The Honorable Ron Wyden Chairman Ranking Member Senate Finance Committee Senate Finance Committee 219 Dirksen Senate Building 221 Dirksen Senate Building Washington,

More information

An Internist s Practical Guide to Understanding Health System Reform

An Internist s Practical Guide to Understanding Health System Reform An Internist s Practical Guide to Understanding Health System Reform Prepared by: ACP s Division of Governmental Affairs and Public Policy Updated October 2013 How to cite this guide: American College

More information

Medicare Access and CHIP Reauthorization Act of 2015 Merit-Based Incentive Payment System and Alternative Payment Model Provisions

Medicare Access and CHIP Reauthorization Act of 2015 Merit-Based Incentive Payment System and Alternative Payment Model Provisions Medicare Access and CHIP Reauthorization Act of 2015 Merit-Based Incentive Payment System and Alternative Payment Model Provisions Department of Health & Human Services Centers for Medicare & Medicaid

More information

SOUTH CAROLINA HOSPITAL ASSOCIATION FEDERAL PRIORITIES

SOUTH CAROLINA HOSPITAL ASSOCIATION FEDERAL PRIORITIES SOUTH CAROLINA HOSPITAL ASSOCIATION FEDERAL PRIORITIES Hospitals serve an important role in communities across the country and in South Carolina. They are instrumental in maintaining and strengthening

More information

10/19/2015. Meaningful Use: Current and Future Environment. Agenda. MGMA Annual Conference Nashville, TN October 13, 2015

10/19/2015. Meaningful Use: Current and Future Environment. Agenda. MGMA Annual Conference Nashville, TN October 13, 2015 Meaningful Use: Current and Future Environment MGMA Annual Conference Nashville, TN October 13, 2015 Agenda Current Environment Stage 2 Flexibility Final Rule Key challenge for practices A look Ahead at

More information

Health Insurance Reform Outlook

Health Insurance Reform Outlook Health Insurance Reform Outlook August 2009 by Janet Trautwein CEO, National Association of Health Underwriters Introduction Legislating health care reform in 2009 is the major priority of the Obama administration

More information

Medicare Shared Savings Program

Medicare Shared Savings Program Medicare Shared Savings Program Shared Savings Program http://www.cms.gov/savingsprogram/ Centers for Medicare & Medicaid Services February 2012 Medicare Shared Savings Program (Shared Savings Program)

More information

Funding for Clinical Services in Academic Departments in the World of ACOs and Health Care Reform

Funding for Clinical Services in Academic Departments in the World of ACOs and Health Care Reform Funding for Clinical Services in Academic Departments in the World of ACOs and Health Care Reform 2015 Association of Professors of Dermatology Annual Meeting Atul Grover, M.D., Ph.D. Chief Public Policy

More information

Comments on the 21 st Century Cures: Digital Health Care

Comments on the 21 st Century Cures: Digital Health Care Comments on the 21 st Century Cures: Digital Health Care July 22, 2014 The Pharmaceutical Research and Manufacturers of America (PhRMA) appreciates the opportunity to provide input to the House Energy

More information

AMC/NOMA Article -- Stimulus Package Promotes Health IT Adoption Amy S. Leopard Walter & Haverfield LLP

AMC/NOMA Article -- Stimulus Package Promotes Health IT Adoption Amy S. Leopard Walter & Haverfield LLP AMC/NOMA Article -- Stimulus Package Promotes Health IT Adoption Amy S. Leopard Walter & Haverfield LLP The Obama Administration clearly expects every American to have an electronic medical record by 2014.

More information

Frequently Asked Questions American Recovery and Reinvestment Act and the HITECH Act. Basics of the Bill

Frequently Asked Questions American Recovery and Reinvestment Act and the HITECH Act. Basics of the Bill Frequently Asked Questions American Recovery and Reinvestment Act and the HITECH Act Basics of the Bill How does the $19 billion that s allocated to Health IT break down in the Stimulus Bill? There is

More information

SHARP: An ONC Perspective 2010 Face-to-Face Meeting

SHARP: An ONC Perspective 2010 Face-to-Face Meeting SHARP: An ONC Perspective 2010 Face-to-Face Meeting Wil Yu, Special Assistant, Innovations and Research Wil.Yu@HHS.gov Office of the National Coordinator for Health Information Technology (ONC) President

More information

The Patient Protection & Affordable Care Act: Next Steps in Maine. February 8, 2013 1

The Patient Protection & Affordable Care Act: Next Steps in Maine. February 8, 2013 1 The Patient Protection & Affordable Care Act: Next Steps in Maine February 8, 2013 1 Maine Medical Association Voluntary membership association of over 3,600 Maine physicians, residents, and medical students

More information

The Affordable Care Act (ACA) in 2015. Lecture Three Christopher Wren Association GL-B31 May 13, 2015 Harry Cain (hcainconsult@gmail.

The Affordable Care Act (ACA) in 2015. Lecture Three Christopher Wren Association GL-B31 May 13, 2015 Harry Cain (hcainconsult@gmail. The Affordable Care Act (ACA) in 2015 Lecture Three Christopher Wren Association GL-B31 May 13, 2015 Harry Cain (hcainconsult@gmail.com) Today s agenda Finish discussion of Medicare Some philosophical

More information

Patient-Centered Medical Home and Meaningful Use

Patient-Centered Medical Home and Meaningful Use Health Home Series: Patient-Centered Medical Home and Meaningful Use Presenters: Christine Stroebel, MPH, PCIP/NYC REACH Natalie Fuentes, MPH, PCIP/NYC REACH Alan Silver, MD, MPH/IPRO March 27, 2012, 2:00

More information

Quality Incentives for Medicare+Choice Plans

Quality Incentives for Medicare+Choice Plans No. 11, August 2002 Quality Incentives for Medicare+Choice Plans Lynn Etheredge Robert Berenson Jack Ebeler 2131 K Street, NW + Suite 500 + Washington, DC 20037 + 202/872-4036 + Fax 202/785-4749 Abstract:

More information

AHIP Comments to House Ways and Means Committee Work Groups Urging Repeal of the ACA Health Insurance Tax

AHIP Comments to House Ways and Means Committee Work Groups Urging Repeal of the ACA Health Insurance Tax AHIP Comments to House Ways and Means Committee Work Groups Urging Repeal of the ACA Health Insurance Tax April 12, 2013 I. Introduction America s Health Insurance Plans (AHIP) is the national trade association

More information

Accountable Care Organizations: What Providers Need to Know

Accountable Care Organizations: What Providers Need to Know DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Accountable Care Organizations: FACT SHEET Overview http://www.cms.gov/sharedsavingsprogram On October 20, 2011, the Centers

More information

OUTLINE OF HEALTH CARE OVERHAUL LEGISLATION

OUTLINE OF HEALTH CARE OVERHAUL LEGISLATION OUTLINE OF HEALTH CARE OVERHAUL LEGISLATION PREPARED FOR AOA MEMBERS BY THE WASHINGTON OFFICE, MARCH 2010 More than 16 months after a far-reaching overhaul of the nation s health care system became the

More information

The Patient Protection and Affordable Care Act. Implementation Timeline

The Patient Protection and Affordable Care Act. Implementation Timeline The Patient Protection and Affordable Care Act Implementation Timeline 2009 Credit to Encourage Investment in New Therapies: A two year temporary credit subject to an overall cap of $1 billion to encourage

More information

HEALTH POLICY ISSUE BRIEF JANUARY 2015

HEALTH POLICY ISSUE BRIEF JANUARY 2015 HEALTH POLICY ISSUE BRIEF JANUARY 2015 Medicare Physician Payment Reform: Securing the Connection Between Value and Payment AUTHORS Mark McClellan, Robert Berenson, Michael Chernew, William Kramer, David

More information

Medicare Program; Request for Information Regarding Implementation of the Merit

Medicare Program; Request for Information Regarding Implementation of the Merit This document is scheduled to be published in the Federal Register on 10/20/2015 and available online at http://federalregister.gov/a/2015-26568, and on FDsys.gov DEPARTMENT OF HEALTH AND HUMAN SERVICES

More information

HCIT and the Stimulus

HCIT and the Stimulus HCIT and the Stimulus The American Recovery & Reinvestment Act of 2009 Derek Schoonover VP & GM, Medisoft & Lytec McKesson Physician Practice Solutions May 19, 2009 Corporate Public Affairs MBA Intern

More information

Panacea Healthcare Solutions, Inc.

Panacea Healthcare Solutions, Inc. Panacea Healthcare Solutions, Inc. The Impact of Value-Based Purchasing in the Healthcare Industry Kim Charland, BA, RHIT, CCS Senior Vice President Clinical Innovation, Panacea Healthcare Solutions and

More information

CMS s framework for Value Modifier

CMS s framework for Value Modifier CMS s framework for Value Modifier Relationship between quality of care, cost composites and the Value Modifier Clinical Care Patient Experience Population/ Community Health Patient Safety Care Coordination

More information

Courtesy of Columbia University and the ONC Health IT Workforce Curriculum program

Courtesy of Columbia University and the ONC Health IT Workforce Curriculum program Special Topics in Vendor-Specific Systems: Quality Certification of Commercial EHRs Lecture 5 Audio Transcript Slide 1: Quality Certification of Electronic Health Records This lecture is about quality

More information

ICP, UnitedHealthcare Terms in Brief

ICP, UnitedHealthcare Terms in Brief Volume 3, Number 5, May 2015 ICP, UnitedHealthcare Terms in Brief ICP has signed a letter of agreement (LOA) with UnitedHealthcare and Oxford Health Plans (a United company) for Commercial, Individual

More information

American Recovery & Reinvestment Act of 2009 Increasing Access to HIT

American Recovery & Reinvestment Act of 2009 Increasing Access to HIT American Recovery & Reinvestment Act of 2009 Increasing Access to HIT Robert Hunter, DO, FACOEP, FACOFP Health Policy Fellowship Class of 2010 Acknowledgments AOA Bureau of Federal Health Programs Ohio

More information