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Medicare Accountable Care Organizations Physicians

Benesch

CMS’s CY 2026 Fee Schedule Proposal: MSSP Reforms Take Center Stage in Push Toward Value

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On July 14, 2025, the Centers for Medicare & Medicaid Services (“CMS”) released the proposed rule for the Calendar Year (“CY”) 2026 Medicare Physician Fee Schedule (“PFS”), formally titled CMS-1832-P....more

Bass, Berry & Sims PLC

New CMS Policies Position the MSSP for Expansion and Increased Savings

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New policies tucked into the Centers for Medicare and Medicaid Services’ (CMS) 2025 Medicare Physician Fee Schedule Rule (Final Rule) will likely spur increased Accountable Care Organization (ACO) participation in the...more

Holland & Knight LLP

CMS Issues 2023 Medicare Physician Fee Schedule Final Rule

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The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2023 Medicare Physician Fee Schedule (PFS) Final Rule on Nov. 1, 2022, which impacts Medicare Part B payments starting on Jan. 1, 2023....more

McDermott Will & Schulte

[Webinar] CMS Direct Contracting Model: Evaluating Participation and Managing Risk - December 1st, 1:30 pm - 2:30 pm EST

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The Centers for Medicare and Medicaid Services (CMS) Direct Contracting Model presents an exciting move towards value-based care with benefits for participants, providers and patients alike. However, the model raises a number...more

K&L Gates LLP

K&L Gates Triage: ACO Quality Reporting in 2021: Key Changes from the Medicare Physician Fee Schedule Proposed Rule

K&L Gates LLP on

In this week’s episode, Limo Cherian, Steve Pine, and Macy Flinchum discuss some of the key changes for Accountable Care Organizations (ACOs) in the recent Medicare Physician Fee Schedule proposed rule. In particular, the...more

Ballard Spahr LLP

CMS and OIG Release Long-Awaited Stark Law and Anti-Kickback Statute Proposed Rules

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The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) recently released two proposed rules restructuring the Physician Self-Referral...more

Dorsey & Whitney LLP

CMS’s New “Primary Cares Initiative” Places Primary Care at the Center of the Shift to Value-Based Care

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On April 22, 2019, the Centers for Medicare and Medicaid Services (CMS) announced two sweeping new payment innovation models under the Primary Cares Initiatives. The models will seek to incentivize primary care and other...more

Robinson+Cole Health Law Diagnosis

2019 Physician Fee Schedule Rule Review: Option to Extend MSSP Agreements for Currently-Expiring ACOs Finalized

On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) released its 2019 Physician Fee Schedule Final Rule (PFS Rule), which contains a number of significant substantive changes to Medicare payment practices...more

Husch Blackwell LLP

Performance Report: “Pathways” Rules Help CMS Advance Two-Sided Risk Sharing

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This is the second article in our series on the new “Pathways” rules for Accountable Care Organizations. The Centers for Medicare and Medicaid Services (CMS) released a report on August 27, 2018, showing Next Generation...more

Verrill

No Summer Slump for CMS: Major Changes Proposed for the Medicare Shared Savings Program

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On August 17, 2018, the Centers for Medicare & Medicaid Services (“CMS”) officially published a proposed rule (“Proposed Rule”) in the Federal Register that would significantly alter the Medicare Shared Savings Program...more

Husch Blackwell LLP

CMS Proposed Rule Would Redesign Medicare Shared Savings Program

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In an August 9, 2018 proposed rule, the Centers for Medicare & Medicaid Services (CMS) seeks to redirect the Medicare Shared Savings Program (MSSP) on so-called “Pathways to Success.”...more

Bradley Arant Boult Cummings LLP

CMS Proposes Redesign of Medicare Shared Savings Program - Healthcare Alert

On August 9, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would redesign the Medicare Shared Savings Program (MSSP). The proposed changes would accelerate the risks associated with...more

Foley & Lardner LLP

Proposed Overhaul to the Medicare Shared Savings Program Would Mean More Risk for ACOs

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On August 9, 2018, CMS introduced a proposed rule that would substantially overhaul the Medicare Shared Savings Program (MSSP), requiring Accountable Care Organizations (ACOs) that participate in the MSSP to accept some...more

Miles & Stockbridge P.C.

The Maryland Primary Care Program – An Important Financial Opportunity for Maryland Physicians

The Maryland Primary Care Program (“MDPCP”) is an unprecedented opportunity for certain health care providers and supporting entities to receive compensation for their efforts to coordinate care and reduce potentially...more

Proskauer Rose LLP

CMS Issues Proposed Rule with Significant Revisions to the Medicare Physician Fee Schedule and Other Payment Policies

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On July 12, 2018, the Centers for Medicare & Medicaid Services ("CMS") issued a proposed rule that includes proposals to update payment policies and rates for services furnished under the Medicare Physician Fee Schedule...more

Foley & Lardner LLP

Top 5 Ways Telehealth Will Change Under the New Federal Funding Bill

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The telemedicine industry has been abuzz upon learning that provider-friendly legislation was included in the new federal Bipartisan Budget Act of 2018, signed into law by the President on February 9, 2018. But telehealth...more

Epstein Becker & Green

MACRA Physician Payment Reform: Time to Take Stock of What Is Working and What Changes Are Needed

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In April 2015, Congress established a new framework for Medicare Part B physician payments through the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”), which the Centers for Medicare & Medicaid...more

Baker Donelson

Proposed Telehealth Expansion of Medicare Reimbursement

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Telehealth continues to be a frontrunner on one strategy to achieve the triple aim, an effort to improve patient experience, population health and reduce per capita cost. To date, government reimbursement for telehealth...more

Sheppard Mullin Richter & Hampton LLP

The Financial Impact of MACRA – Uncertainty Reigns in a Recent Rand Corporation Study

With all the talk of the Affordable Care Act’s uncertain future, it is easy to forget about the Medicare Access and CHIP Reauthorization Act (“MACRA”), a bipartisan law passed by Congress in 2015 to change the way physicians...more

Snell & Wilmer

The MACRA Final Rule: In Search of the “Goldilocks” Model

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The Medicare Access and CHIP Reauthorization Act (“MACRA”) Final Rule published late last year implements CMS’ new payment approach for physicians and other Medicare Part B eligible clinicians under the Merit-Based Incentive...more

Pierce Atwood LLP

CMS Continues Efforts to Improve Patient Care, Spending, and Population Health

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On November 2, 2016, the Centers for Medicare and Medicaid Services (CMS), released the 2017 Medicare Physician Fee Schedule (MPFS) final rule, which finalized a number of new policies designed to improve Medicare payment for...more

Sheppard Mullin Richter & Hampton LLP

“May You Live in Interesting Times” – Some Healthcare Predictions for the Trump Administration’s First Year

The ancient Chinese curse – “May you live in interesting times” – certainly springs to mind these days. What does the election of Donald Trump mean for the healthcare industry, the Affordable Care Act and current healthcare...more

BakerHostetler

Making Sense of MACRA

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The countdown has begun for the momentous Part B payment reforms created by the Medicare Access and Chip Reauthorization Act of 2015 (MACRA). On October 14, 2016, CMS released a final rule explaining, in nearly 2,400 pages,...more

Polsinelli

Making Sense of the MACRA Final Rule, Part 2 of 3: Alternative payment Models

Polsinelli on

Many observers view the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as a game changer for the delivery and payment of health care services. On Oct. 14, 2016 the Centers for Medicare & Medicaid Services...more

Pierce Atwood LLP

CMS Releases List of Additional Advanced APM’s and Announces Vermont’s All-Payer ACO

Pierce Atwood LLP on

On the heels of the release of its final rule implementing the Medicare Access and CHIP Reauthorization Act (MACRA), the Centers for Medicare and Medicaid Services (CMS) released its 2017 list of Advanced Alternative Payment...more

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