Black Friday at CMS: Request for Information Regarding Health Care Quality for Exchanges

By On November 23, 2012 · Leave a Comment

Today (11/23/2012), CMS released this request for information (RFI)  (temporary link) seeking public comments on health care quality management in the “Affordable Insurance Exchanges.”  The Federal Register will officially publish the RFI next Tuesday, November 27, 2012, and public comments will be due by 5 PM (EST) on Thursday, December 27, 2012.

Background

The [...]

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The Looming Fiscal Cliff: CMS Releases Physician Fee Schedule Final Rule Threatening 26.5% Cut Unless Congress Acts

By On November 1, 2012 · Leave a Comment

Today (November 1, 2012), the Centers for Medicare & Medicaid Services (CMS) issued its annual Medicare Physician Fee Schedule Rule (temporary link).  This final rule updates payment policies and rates for physicians and nonphysician practitioners (NPPs) for services paid under the Medicare Physician Fee Schedule (MPFS) in calendar year (CY) 2013.  CMS is accepting [...]

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The Health Reform Lawsuit: Individual Mandate Upheld & States Earn Right to Opt-Out of Medicaid Expansion

By On June 29, 2012 · Leave a Comment

Yesterday, the U.S. Supreme Court announced its opinion in the National Federation of Independent Business v. Sebelius which tested the constitutionality of two key provisions included in the Patient Protection and Affordable Care Act (PPACA):

The individual mandate to purchase health insurance The expansion of Medicaid to [...]

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Our Thoughts on the Supreme Court Case

By On March 30, 2012 · Leave a Comment

After a busy week considering the constitutionality of the Patient Protection and Affordable Care Act, Justice Thomas was as tight-lipped off the bench regarding his views on the case as he was during the oral arguments.  In fact, I didn’t ask him about health reform when I spoke with him yesterday because I felt it [...]

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Aligning Your Health System’s Conflict Of Interest Policies with the Physician Payment Sunshine Act

By On February 15, 2012 · Leave a Comment

There are only a couple of days left until the comment period closes on CMS’ proposed rule implementing the Physician Payment Sunshine Act.  So, I thought it would be timely to share my article on how the new law could affect health systems and prompt revisions to existing conflict of interest policies that was [...]

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Accountable Care Organizations Decoded

By On January 5, 2012 · Leave a Comment

Today, the Centers for Medicare and Medicaid Services (CMS) hosted an open-door forum to help prospective applicants for the Advance Payment Initiative associated with the Medicare Shared Savings Program.  Questions posed by participants in the call indicated there may be some confusion among health care providers regarding what an Accountable Care Organization is, who can [...]

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Survey: Two-Thirds of Americans Believe Government and Insurers are Denying Access to Drugs Based on Cost Alone

By On December 22, 2011 · Leave a Comment

 

Moving Along the Guiderails: How Does the Public View Comparative Effectiveness Research and Cost Cutting Measures.

On December 22, the Alliance for Aging Research presented a webcast presenting a survey titled, “Four-Country Comparative Effectiveness Decision-Making and Patient Access Survey.”  The key findings of the survey include:

Most Americans oppose government or insurance company decisions [...]

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CMS Publishes Physician Payment Sunshine Proposal

By On December 15, 2011 · Leave a Comment

Proposed Rule:  Medicare, Medicaid, Children’s Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests (CMS-5060-P)

Yesterday (12/14/11), CMS released its proposed rule implementing the provisions of section 6002 of the Patient Protection and Affordable Care Displayed (Public Law 111-148), also known as the Physician Payment Sunshine Act (PPSA).  Comments are due [...]

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Inside Health Policy: CMS, Facing Congressional Pressure, Excludes Some Wheelchairs From Round 2 DME Bidding

By On December 1, 2011 · Leave a Comment

From InsideHealthPolicy.com

CMS on Wednesday revealed that it will exclude some types of wheelchairs and their accessories from the second round of the durable medical equipment competitive bidding program, a move that came after industry lobbied the agency and got two lawmakers to weigh in, an industry source says.

The agency also announced the [...]

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HME News: Q&A with Applied Policy’s Jim Scott

By On September 19, 2011 · Leave a Comment

‘The idea is not to get in a fight with CMS’ Q&A with Applied Policy’s Jim Scott By Elizabeth Deprey, Associate Editor – 09.16.2011

 

WASHINGTON – A new name popped onto the competitive bidding radar screen during CMS’s Open Door Forum last month.

That’s when Drew Saelens of Applied Policy asked agency officials when [...]

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