Latest News

<< First  < Prev   1   2   Next >  Last >> 
  • 10/12/2017 6:00 PM | Rebekah Francis (Administrator)

    The Independent Payment Advisory Board (IPAB) could finally be coming to an end. Last week, the House Ways and Means Committee approved bipartisan legislation (H.R. 849) to repeal the IPAB, a cost containment tool mandated by the Affordable Care Act to convene if Medicare spending exceeds a specified limit. The IPAB has significant power to make changes to Medicare spending, leaving little-to-no room for recourse if IPAB-mandated payment cuts are triggered.

    It is paramount that Congress act now and pass this important legislation before future actuary reports trigger the IPAB and activate payment reductions to Medicare providers. Contact your member of Congress now via MGMA's Advocacy Center and urge lawmakers to support this important legislation.

  • 10/12/2017 5:58 PM | Rebekah Francis (Administrator)

    CMS released a new tool that allows clinicians and practices to look up whether they achieved qualified participant (QP) status in an Advanced APM for the 2017 performance year based on claims data with dates of service from January through March. As a reminder, those who achieve QP status in 2017 are eligible for a 5% lump sum bonus and exempt from MIPS in 2019. Clinicians who did not qualify during the first claims analysis will have two more opportunities to achieve QP status this year based on claims data from April through June and July through August. For more information visit MGMA's APM resource center.

  • 10/05/2017 11:42 AM | Rebekah Francis (Administrator)

    After an aggressive advocacy effort by MGMA, CMS released guidance on the issues of Electronic Funds Transfer (EFT) payments and the use of “virtual” credit cards (VCCs). Health plans sending VCCs must stop if a provider requests to receive payments via EFT. Most importantly, health plans (or their payment vendors) must not charge providers unsanctioned fees for the use of EFT. Permissible fees are limited to banking fees, typically around $.034 per transaction. In addition, practices are not required to contract for additional “value added” payment services from vendors and signing up for EFT does not automatically allow the plan to deduct funds from a provider’s account unless contractually authorized by the provider to do so. Access the MGMA member-benefit EFT/ERA Guide for more information and our sample letter to request payment via EFT.

  • 10/05/2017 11:41 AM | Rebekah Francis (Administrator)

    MGMA joined the American Medical Association and more than 100 physician specialty and state medical organizations in a letter urging Congress to ensure smooth implementation of Medicare payment policies under the Medicare Access and CHIP Reauthorization Act (MACRA). In particular, MGMA and the medical community call for a three-year extension of program flexibility to ensure physician practices are able to successfully participate in the new Merit-Based Incentive Payment System (MIPS) while CMS finalizes cost measures, improves data feedback, and provides tools to improve performance. Among other refinements, the letter requested clarification that Medicare Part B drugs are outside the scope of MIPS payment adjustments.

  • 10/05/2017 11:40 AM | Rebekah Francis (Administrator)

    MGMA offered recommendations to reduce unnecessary government regulations at the U.S. Department of Health and Human Services (HHS) “Cut the Red Tape” Summit this week. During their opening remarks, HHS Acting Secretary, Dr. Don Wright, CMS Administrator, Seema Verma, and other HHS officials reiterated the Department’s commitment to reducing excessive regulatory burdens on medical group practices. During the panel discussion, Anders Gilberg, MGMA’s Senior Vice President of Government Affairs, shared results from MGMA’s 2017 Regulatory Burdens survey that highlighted the considerable time and resources required to comply with federal mandates and identified key areas of concern for medical group practices, such as the lack of clinical relevance in Medicare’s Quality Payment Program. MGMA will continue to call on HHS to support innovative, high-quality, and cost-effective care delivery untethered from excessive, one-size-fits-all regulations. 

  • 10/05/2017 11:38 AM | Rebekah Francis (Administrator)

    The Centers for Medicare & Medicaid Services (CMS) withdrew its proposal to change the way Medicare pays for drugs administered in physician offices. MGMA raised significant concerns regarding the proposed payment model, which would have reduced Medicare reimbursement without addressing the root cause of drug price increases set by the manufacturer. The Association also took issue with the fact that this mandatory model would establish a precedent under which the CMS Innovation Center could expand its limited legislative authority to circumvent the usual channels for changing physician payment. MGMA continues to recommend the agency seek physician practice input in developing payment models to support innovative approaches to improve quality and affordability without restricting patient access to life-saving treatments.

  • 09/27/2017 4:58 PM | Rebekah Francis (Administrator)

    Group practices and eligible clinicians (ECs) seeking to earn a bonus in the Merit-Based Incentive Payment System (MIPS) in 2019 have until Oct. 2 to begin reporting one or more quality measures, improvement activities, or Advancing Care Information measures for the minimum 90 consecutive days. Conversely, group practices and ECs have through the end of the calendar year to avoid a 4% MIPS penalty in 2019 by reporting at least one quality measure on one patient. MGMA encourages practice executives to protect their practice from a Medicare payment cut by reporting more than one measure as an insurance policy in case the group encounters any data submission issues or inaccuracies. For resources to help your practice successfully participate in MIPS, visit MGMA.org/MACRA.

  • 09/27/2017 4:57 PM | Rebekah Francis (Administrator)

    The latest Affordable Care Act (ACA) replacement proposal will not be brought to a vote in the Senate, after Susan Collins, R-ME, became the third Republican to publicly come out against it. MGMA expressed concerns over this latest proposed Senate bill based on our healthcare reform principles. The Senate appears willing to resume its own bipartisan efforts to stabilize the exchanges for next year.

  • 09/18/2017 4:20 PM | Rebekah Francis (Administrator)

    CMS announced last month it will launch a new audit strategy, called Targeted Probe and Educate (TPE), after pilot programs with four Medicare Administrative Contractors (MACs) demonstrated success. Under the TPE approach, MACs will perform reviews on claims that pose the greatest financial risk to the Medicare trust fund or have a high national error rate. Unlike the previous policy where reviews were initiated on all providers of a particular service, MACs are now instructed to focus only on those providers, identified through data analysis, who have the highest claims error rates or billing practices that vary significantly from their peers. The TPE program includes up to three rounds of review, coupled with individualized education based on review results, and is expected to be expanded to all MAC jurisdictions - later this year.

  • 09/18/2017 4:19 PM | Rebekah Francis (Administrator)

    Department of Health and Human Services (HHS) Secretary Tom Price, MD issued responses to the first physician focused payment models (PFPMs) reviewed by the PFPM Technical Advisory Committee (PTAC) in April. The Secretary asked that design concerns be addressed before making a final decision on the American College of Surgeons-Brandeis Model. HHS also indicated it would not be moving forward with the COPD and Asthma Monitoring Project and Project Sonar models, but would consider elements of those proposals when developing its own future models. Despite not proceeding with any of the proposals at this time, Price provided valuable insights to guide development of future PFPMs. He explained models that are broad in scope and feature enhanced patient monitoring to reduce complications and hospital admissions hold promise but that HHS is not interested in models that would not be implemented beyond the submitter or use proprietary technology.

<< First  < Prev   1   2   Next >  Last >> 

OUR GOAL

To develop and equip our members to create dynamic, successful medical group practices.

OUR VISION

To be the recognized leader in defining and supporting the profession of medical practice management in Tennessee.

CONTACT US

PO Box 380963
Birmingham, AL 35238
rebekahfrancis@bellsouth.net

(573) 556-6111


Our Sponsors

Copyright 2017, TMGMA.com | rebekahfrancis@bellsouth.net