The Centers for Medicare & Medicaid Services (CMS) is providing notifications to facilities that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for CY 2023, which will affect their FY 2025 Annual Payment Update (APU). Non-compliance notifications are being distributed by the Medicare Administrative Contractors (MACs) and were placed into facilities’ CASPER folders in QIES, for Hospices and into facilities’ My Reports folders in the Internet Quality Improvement and Evaluation System (iQIES), for IRFs, LTCHs and SNFs, on July 03, 2024. Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 pm, August 14, 2024. https://cstu.io/8bece0
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What is the Medicare Shared Savings Program? Medicare Shared Savings Program (MSSP) is a program created by the Centers for Medicare & Medicaid Services (CMS) that promotes accountability among providers and reduces costs for beneficiaries. As part of the MSSP, providers are encouraged to form Accountable Care Organizations (ACOs) to provide high-quality coordinated care at a lower cost to Medicare beneficiaries. ACOs are groups of providers who work together to provide coordinated, high-quality care to Medicare patients. The MSSP provides incentives for ACOs that can reduce costs while maintaining or improving quality of care. ACOs must meet certain quality standards and share in the savings they achieve. If an ACO meets the required quality metrics and saves money, they will receive a portion of the savings. If an ACO does not meet the quality measures or fails to save money, they are not eligible to receive any shared savings. Need no cost help? Call Sheryl Gulan Lic #19582450
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Just announced by Centers for Medicare & Medicaid Services (CMS), process improvements for the Medicare Secondary Payer Recovery Portal (MSPRP) to accept additional documentation via the portal to decrease the amount of paper correspondence and make the process more efficient when handling redetermination requests, exhaustion letters, status inquiries and other documentation submissions. Full details regarding the change will be made available in the January 2024 version of the MSPRP User Guide. #CMS #MSPN #claimsmanagement
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Great news! CMS just announced they have made updates to the portal to accept documentation which will improve the efficiency of submission documentation and processing. You can read the announcement here https://lnkd.in/gRypRWSq #allankoba #MSP #CMS
Just announced by Centers for Medicare & Medicaid Services (CMS), process improvements for the Medicare Secondary Payer Recovery Portal (MSPRP) to accept additional documentation via the portal to decrease the amount of paper correspondence and make the process more efficient when handling redetermination requests, exhaustion letters, status inquiries and other documentation submissions. Full details regarding the change will be made available in the January 2024 version of the MSPRP User Guide. #CMS #MSPN #claimsmanagement
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CEO/Founder GMS Health Plan Services. 30 years of experience supporting health care organizations with Member Outreach, Compliance, HEDIS and STARS programs.
https://lnkd.in/eiFUsj5N The Centers for Medicare & Medicaid Services have finalized changes to Medicare Advantage plan capitation rates and Part C and Part D payment policies for 2025. These changes are expected to increase MA plan revenues by an average of 3.7% from 2024 to 2025. The notice includes adjustments to the Part C risk adjustment model, updates to Part C and D star ratings, stability adjustments for the MA program in Puerto Rico, and implementation of changes to the standard Part D drug benefit. CMS also encourages stakeholders to provide feedback through the Medicare Advantage Data Request for Information, with comments due by May 29. #MemberOutreach #MemberEngagement #MedicareCoverage #MedicareAdvantage #MedicarePlans #HealthcareBenefits #MedicareEnrollment #HealthcareAccess #MedicareServices #MemberSupport #Redetermination #MedicareAdvocacy #HealthcareNavigation #MedicareAssistance
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https://lnkd.in/drXkBTiu The Centers for Medicare & Medicaid Services have finalized changes to Medicare Advantage plan capitation rates and Part C and Part D payment policies for 2025. These changes are expected to increase MA plan revenues by an average of 3.7% from 2024 to 2025. The notice includes adjustments to the Part C risk adjustment model, updates to Part C and D star ratings, stability adjustments for the MA program in Puerto Rico, and implementation of changes to the standard Part D drug benefit. CMS also encourages stakeholders to provide feedback through the Medicare Advantage Data Request for Information, with comments due by May 29. #MemberOutreach #MemberEngagement #MedicareCoverage #MedicareAdvantage #MedicarePlans #HealthcareBenefits #MedicareEnrollment #HealthcareAccess #MedicareServices #MemberSupport #Redetermination #MedicareAdvocacy #HealthcareNavigation #MedicareAssistance
CMS finalizes Medicare Advantage, Part D payment changes for CY 2025 | AHA News
aha.org
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Has the Medicare Shared Savings Program (MSSP) resulted in net savings to the Centers for Medicare & Medicaid Services (CMS)? YES!! But the devil is in the details… I just read a study by JAMA which quantified net savings to the Centers for Medicare & Medicaid Services (CMS) from the MSSP from 2013 to 2021. The study found that the MSSP was associated with: NET LOSSES to traditional Medicare (reductions in traditional Medicare were smaller than incentive payments made) NET SAVINGS to MA (via reduced MA benchmarks), and OVERALL NET SAVINGS to CMS. Very interesting to think about the interplay between programs especially for our many ACO clients taking risk on both traditional Medicare and Medicare Advantage lives! Zach Davis See figure below for details. Article is linked in comments. #MSSP #CMS #MedicareAdvantage #GrossSavings #NetSavings #SharedSavings #Valuebasedcare #SOAHealth #JAMA #MABenchmarks
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On February 29, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Medicare Prescription Payment Plan: Final Part One Guidance on Select Topics, Implementation of Section 1860D-2 of the Social Security Act for 2025, and Response to Relevant Comments memorandum and fact sheet. BluePeak has created a summary of the guidance and outlines next steps for Plan Sponsors to consider. Contact us at info@bluepeak.com to receive your copy. Just ask for the M3P Final Part One Guidance Summary! BluePeak has already started working with Plans, PBMs and vendors on this topic. This guidance has far-reaching operational implications for Plans and its members, and its implementation will require cross-functional coordination to manage and oversee the program. BluePeak is providing full-service support of M3P including vendor identification and selection, implementation support, communication and training for all stakeholders as well as oversight and monitoring. Contact at info@bluepeak.com for a free consultation on M3P.
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Upcoming DIR Fee Changes and Their Potential Impact on 340B Programs - https://lnkd.in/ear2uC2B SPONSORED CONTENT The Centers for Medicare & Medicaid Services (CMS) has issued a final rule that goes into effect on January 1, 2024 that changes the way Direct and Indirect Remuneration (DIR) fees are collected. To understand the impact of this change, let’s review some background [...] #340B
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Final Part One Guidance is Out! We are here to help you make sense of it all!!
On February 29, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Medicare Prescription Payment Plan: Final Part One Guidance on Select Topics, Implementation of Section 1860D-2 of the Social Security Act for 2025, and Response to Relevant Comments memorandum and fact sheet. BluePeak has created a summary of the guidance and outlines next steps for Plan Sponsors to consider. Contact us at info@bluepeak.com to receive your copy. Just ask for the M3P Final Part One Guidance Summary! BluePeak has already started working with Plans, PBMs and vendors on this topic. This guidance has far-reaching operational implications for Plans and its members, and its implementation will require cross-functional coordination to manage and oversee the program. BluePeak is providing full-service support of M3P including vendor identification and selection, implementation support, communication and training for all stakeholders as well as oversight and monitoring. Contact at info@bluepeak.com for a free consultation on M3P.
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Our in-depth summary outlines what plans need to do and consider for this implementation. Contact me if you want a copy of our summary.
On February 29, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Medicare Prescription Payment Plan: Final Part One Guidance on Select Topics, Implementation of Section 1860D-2 of the Social Security Act for 2025, and Response to Relevant Comments memorandum and fact sheet. BluePeak has created a summary of the guidance and outlines next steps for Plan Sponsors to consider. Contact us at info@bluepeak.com to receive your copy. Just ask for the M3P Final Part One Guidance Summary! BluePeak has already started working with Plans, PBMs and vendors on this topic. This guidance has far-reaching operational implications for Plans and its members, and its implementation will require cross-functional coordination to manage and oversee the program. BluePeak is providing full-service support of M3P including vendor identification and selection, implementation support, communication and training for all stakeholders as well as oversight and monitoring. Contact at info@bluepeak.com for a free consultation on M3P.
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