News & Updates from CMS

cms-PtV-200The Centers for Medicare and Medicaid Services (CMS) is reporting these events, updates and deadlines for providers. These items focus on the agency’s financial and payment responsibilities to providers. Read and sign up for the CMS weekly newsletter MLN Connects® Provider eNews for the most current news.

CMS Seeking Comment on MACRA Episode Groups
As required by Section 101(f) of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), enacted April 16, 2015, CMS is soliciting comment on episode groups, and on specific clinical criteria and patient characteristics to classify patients into care episode and patient condition groups. The purpose is to provide background and context to solicit stakeholder input on the episode groups that the Centers for Medicare & Medicaid Services (CMS) has developed pursuant to section 3003 of the Affordable Care Act (ACA). Comments should be sent to by 11:59 pm EST on February 15, 2016. Please note that comments will not be accepted after this date.

Medicare Quality Reporting Programs Webinar: What Eligible Providers Need to Know in 2016
The CMS Philadelphia Regional Office is hosting webinars on Medicare Quality Reporting Programs: What Eligible Providers Need to Know in 2016. Both sessions will present the same information. Register for a session:

Topics include:

  • Medicare Access and CHIP Reauthorization Act (MACRA) preview
  • 2016 incentive payments and 2018 payment adjustments
  • 2016 Physician Quality Reporting System (PQRS) updates
  • 2018 Value-based Payment Modifier (VM) policies
  • Physician Compare updates for 2016
  • Meaningful use of Certified Electronic Health Record Technology (CEHRT) in 2016

Prohibition on Balance Billing Dually Eligible Individuals Enrolled in the QMB Program
This article was revised on February 4, 2016, to include updated information for 2016 and a correction to the second sentence in paragraph 2 under Important Clarifications Concerning QMB Balance Billing Law on page 3. All other information is the same. This article pertains to all Medicare physicians, providers and suppliers, including those serving beneficiaries enrolled in original Medicare or a Medicare Advantage plan.

How to Use the Searchable Medicare Physician Fee Schedule Booklet
A revised How to Use the Searchable Medicare Physician Fee Schedule Booklet is available. Learn about:

  • Payment information
  • Pricing
  • Relative value units
  • Payment policies

February is American Heart Month
Heart disease is the leading cause of death for men and women in the United States, but it can often be prevented by identifying risk factors and making healthy lifestyle choices. Help your Medicare patients reduce their risk for heart disease and stroke:

  • Recommend appropriate preventive services, including cardiovascular disease screening tests and intensive behavioral therapy for cardiovascular disease
  • Get tools and resources through HHS Million Hearts, a national initiative to prevent a million heart attacks and strokes by 2017