What Physicians need to Know By Steven Lash

steven Lash

Physicians are aware that the 2017 Medicare Physician Fee Schedule (PFS) Final Rule (“Final Rule”) has been finalized and will take effect Jan. 1, 2017.  Among items in the Final Rule which physicians should find important are as follows: The RVU conversion factor has been set at $35.887, which represents an increase of approximately 24% from […]

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Are you ready for MACRA By Steven Lash

steven lash

A majority of physicians are aware of the Medicare Access & CHIP Reauthorization Act (MACRA), and those who do know about it probably want it to go away. Nevertheless, this law will determine how Medicare pays doctors, starting in 2019.  Some modifications in the rules from those published in July 2016 will make things considerably […]

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Medicare Physician Payment By Steven Lash

steven lash

As the largest change in Medicare physician payment since the Sustainable Growth Rate (SGR) formula, the Medicare Access and CHIP Reauthorization Act (MACRA) will impact over 800,000 clinicians and reallocate in excess of $1.2 billion in payments for bonuses and penalties in its first year. The 962 page proposed rule for its implementation generated thousands of pages […]

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Steven Lash Shared Views on MACRA Rules

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Providers are pushing back against the proposed codes to identify which clinicians provide services as promulgated in the draft MACRA rules. The codes are a key component of the payment reform, since they will be utilized to compare resource utilization and outcomes. Industry leaders say the proposed patient relationship codes, which were mandated by the […]

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Medicare ACOs Save $466 Million in 2015 by Steven Lash

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Over 400 Medicare accountable care organizations generated more than $466 million in total program savings in 2015, according to the latest data from CMS. However, Medicare spent $217 million more in bonuses than the ACO program saved.  The data is from the financial results of 392 organizations participating in the Medicare Shared Savings Program and […]

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Comment on Physician Fee Schedule Proposed Changes Steven Lash

steven lash

I am pleased to comment on the proposed Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2017 for doctors and other clinicians under Medicare. In the Notice of Proposed Rule making,published July 15, 2016 (CMS-1654-P), you seek comment on the implementation of changes to Medicare’s payments […]

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Care Plan Oversight (CPO) and Chronic Care Management (CCM) By Steven Lash

Steven Lash

There are a couple of similarities as well as a couple of differences between Chronic Care Management (CCM) and Care Plan Oversight (CPO). Medicare only pays for CPO for beneficiaries who are receiving Medicare home health or Medicare hospice. CPO is similar to CCM because it requires tracking on task for non-face-to-face services, so a […]

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Comprehensive Primary Care Plus (CPC+) Questions and Answers by Steven Lash

steven Lash

CPC+ is a mutli-payer model.  It will only be offered in regions where Medicaid and private payers have offered to participate along with Medicare. 1.Which payers will be involved? This will vary from region to region.  We will know who is involved in each region as soon as the payer bid cycle is concluded (those […]

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