Connect Archives

March 2017

Wednesday, March 29, 2017

CMS DELAYS START OF THE MANDATORY BUNDLED PAYMENT PROGRAMS

The Centers for Medicare and Medicaid Services (CMS) has delayed the implementation of the mandatory bundled payment plans for both the Mandatory Cardiac Bundle (Medicare patients with MI or bypass surgery) and the Mandatory Joint Replacement Bundle (Medicare patients with hip replacement or other treatments for hip and femur fractures) from 07/01/2017 to 10/01/2017, and has also delayed the final rule to implement the Joint Replacement Bundle, the Cardiac Rehabilitation Incentive Payment Model, and the Initiative to Advance Care Coordination through Episode Payment Models from 03/21/2017 until 05/20/2017. CMS is also seeking comment on a potential further delay of these programs until 01/01/2018. All of these programs were set to roll out in select Metropolitan Areas later this year, but CMS feels it needs more time to evaluate the comments that were received. The fact that they are considering a further delay may indicate more problems in the introduction of these programs than was initially anticipated. The Bundled Payment programs are designed to hold the acute care hospitals that are participating in the programs accountable for both the quality and the cost of the acute inpatient stay, and all additional costs incurred for 90 days post-discharge.

WELLCARE’S MEDICARE 2017 PARTNERSHIP FOR QUALITY PROGRAM

WellCare Health Plan values the quality of health care delivered to its members. The Partnership for Quality Program (P4Q) recognizes providers who collaborate to deliver and appropriately document quality care. The program incorporates HEDIS, Continuity of Care and Pharmacy measures into a singular, comprehensive program.

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CMS EXTENDS DEADLINE FOR 2016 PHYSICIAN QUALITY REPORTING SYSTEM (PQRS) ELECTRONIC HEALTH RECORD (EHR) SUBMISSION

CMS has extended the submission deadline for 2016 Quality Reporting Document Architecture (QRDA) data submission for the EHR reporting mechanism of the Physician Quality Reporting System (PQRS) program. Individual eligible professionals (EPs), PQRS group practices, qualified clinical data registries (QCDRs), and qualified EHR data submission vendors (DSVs) now have until Friday, March 31, 2017 to submit 2016 EHR data via QRDA. The deadline is extended to March 31, 2017 for EPs to electronically report electronic Clinical Quality Measures (eCQMs) for the Medicare EHR Incentive Program.

CMS PUBLISHES UPDATED ECQM TABLE FOR ELIGIBLE CLINICIANS AND ELIGIBLE PROFESSIONALS FOR 2017 PERFORMANCE PERIOD

The Centers for Medicare & Medicaid Services (CMS) has published an updated table accompanying the 2016 electronic clinical quality measure (eCQM) specifications (published in April 2016) for the 2017 performance period.

This update removes the previous meaningful use domains and now aligns with the domains listed in the Calendar Year 2016 Medicare Physician Fee Schedule, as well as the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) tracks of the Quality Payment Program.

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TIMELY REPORTING OF PROVIDER ENROLLMENT INFORMATION CHANGES

A 2016 Office of the Inspector General (OIG) report noted that providers may not be informing CMS of changes in their enrollment information. Providers must update their enrollment information within 30 days of the change. Failure to comply could result in revocation of Medicare billing privileges.

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HFNI PROFESSIONAL LIABILITY INSURANCE PROGRAM

Health First Network, Inc. (HFNI) has formed the HFNI Professional Liability Insurance Program, a program designed to enhance the professional liability coverage of our members with available discounts of up to 50% for qualified members.

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HFNI WORKERS COMPENSATION INSURANCE PROGRAM

Did you receive money back on your Workers’ Comp Premium last year? Now you are eligible through the Health First Network Workers’ Compensation Program.

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NEW PHYSICIANS JOINING THE NETWORK

Health First Network would like to welcome the most recent physicians to join the Network:
Geoffrey Fraiche, M.D. Hospitalist
Rahul Chavan, M.D. Dermatology (MOHS Only)
Jennifer Estes, M.D. Hospitalist
Lakeema Bruce, M.D. OB/GYN
David Fiedler, M.D. Surgery of the Hand
Dennis Incorvati, D.O. Cardiology/Cardiovascular Disease
Susan Smith, M.D. Hospitalist
Tiffany Vroon, M.D. Pediatrics

** To determine which health plans each physician is participating in check the “Find A Doctor” section on the HFNI website.

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