PatientEngagementHIT

Policy & Regulation News

Senators Seek Payer, Provider Data on Surprise Medical Bills

February 7, 2019 - A group of US senators are calling on healthcare payers and providers to offer more information about surprise medical bills and balance billing. Ideally, this information will help the legislators supplement their bipartisan bill to combat surprise medical bills. A surprise medical bill is a set of medical charges a patient was not expecting to receive. Surprise bills often occur when...


Articles

CMS Models Target Patient-Centered Benefits Design, Drug Costs

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CMS has revealed two new regulations that will ideally improve patient-centered benefits design and lower prescription drug spending, the agency said. Specifically, the agency announced a new Value-Based Insurance Design (VBID) model and...

New NCQA Population Health Programs Push Patient-Centered Care

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Patient-centered care and population health management are emerging as two key priorities for the National Committee for Quality Assurance (NCQA) as the body announced two new population health programs. The organization has unveiled the...

CMS Updates Aim to Improve Patient-Centered Care, Care Access

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The Centers for Medicare & Medicaid Services has issued a slew of final rules aimed at reducing administrative simplification and improving patient-centered care. Late last week, CMS finalized its 2019 Physician Fee Schedule (PFS),...

HHS Drug Payment Proposal May Cut Out-of-Pocket Patient Costs

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HHS has unveiled the International Pricing Index (IPI), a proposed payment model that would allow Medicare to set drug prices at rates closer to those in other developed nations. This move has the potential to reduce out-of-pocket patient...

Gag Clause Bills Signed into Law, Improves Healthcare Transparency

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President Trump has signed into law two bills that prohibit pharmacy gag clauses, or the practice of prohibiting pharmacy and healthcare transparency. The laws – one targeted at Medicare plans and one for private and...

CMS Announces Patient Navigator Funding, Enrollment Changes

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CMS has announced the recipients of $10 million grant funding for patient navigator programs, considerably slashing the resources states will have to connect patients with comprehensive health insurance. The patient navigator program was...

Experts State 2019 Physician Fee Schedule Harms Patient Care Access

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More healthcare industry leaders are expressing concerns over provisions included in the 2019 proposed Physician Fee Schedule, specifically stating that statutes to reduce reimbursement for evaluation and management (E/M) services could...

CMS Rule May Reduce Reporting Burden, But Harm Patient Care Access

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Proposed changes for the 2019 Physician Fee Schedule would effectively put “patients over paperwork,” helping to deliver on a promise from CMS to improve patient-centered care and patient care access, said the American Medical...

CMS to Drive Community Care Coordination for Behavioral Health

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CMS has announced a new care delivery model that aims to improve preventive care, early detection, and care access for pediatric patients at-risk of having an opioid addiction or behavioral health issue. The Integrate Care for Kids (IncK)...

MyHealthEData, Patients Over Paperwork Key in CMS Final Rules

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CMS has issued final rules related to the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System. Finalized changes will support patient-centered care by reinforcing the MyHealthEData...

Hospitals Say OPPS Proposed Rule Will Harm Patient Access to Care

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Hospital associations across the country are speaking out against the recent CMS proposed Hospital Outpatient Prospective Payment System (OPPS) rule, stating that the rule will hinder patient access to care and increase out-of-pocket...

Verma: CMS Makes Strides in Patient-Centered Care, Medicare Reform

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CMS is making progressing in its mission to fulfill patient needs and drive patient-centered care through various new Medicare policies, agency Administrator Seema Verma said in a speech at the Commonwealth Club of...

CMS Proposed Rule to Let Patients Access Care at Preferred Sites

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CMS has proposed changes to the Medicare Hospital Outpatient Prospective Payment System (OPPS) to create site-neutral payments, thus allowing senior patients to access the care they need in their preferred care site. Creating site-neutral...

Industry Orgs Question CMS Proposals for QPP, Value-Based Care

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As industry organizations begin their in-depth analyses of the recent CMS proposed changes to the Physician Fee Schedule and Quality Payment Program, several have issued preliminary responses saying the rule could hinder provider payments...

Understanding Patient Relationship Codes in MACRA, QPP

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In January 2018, the Centers for Medicare & Medicaid Services (CMS) announced optional reporting for patient relationship codes that would define the purposes for which a clinician treated a patient. Healthcare professionals should opt...

NCQA Testing Patient-Centered Outcomes Measures in Value-Based Care

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The National Committee for Quality Assurance (NCQA) is teaming up with four healthcare providers and payers across the country to test new patient-centered outcomes measures. The project, funded by the John A. Hartford Foundation and The...

CMS Calls for Patient-Centered Data Access in New Agency Initiative

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CMS will be putting patients at the center of healthcare decisions as a part of the Data Driven Patient Care Strategy, an offshoot of the MyHealtheData initiative, CMS Administrator Seema Verma announced this week at the 9th annual Health...

CMS Calls for Hospital Price Transparency Mandates in Proposed Rule

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CMS has proposed updates to its payment programs that could require healthcare organizations to offer price transparency to patients, allowing patients to make well-informed treatment decisions in a time during which patients face high...

Congressional Caucus Calls for Patient-Centered Care, Wellness

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The Integrative Health & Wellness Caucus held its first official meeting addressing patient-centered care and whole-person wellness initiatives. The caucus, launched in October, 2017, aims to support patient needs in healthcare,...

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