SGR Fix

CMS Announces Top 3 Volume to Value Medicare Payment Goals

November 24, 2015 - Patrick Conway, MD, MSc, Chief Medical Officer at the Centers for Medicare & Medicaid Services (CMS), is speaking out about the administration’s overarching goals for Medicare’s future. In yesterday’s blog post, Conway said CMS is indeed diligently working to transition Medicare payments from volume to...


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Are Medicare Pay-for-Performance Benefits Worth the Risk?

by Jacqueline DiChiara

Medicare pay-for-performance (P4P) incentives are inadvertently averting money away from those financially aching hospitals primarily serving minorities and the economically disadvantaged to instead...

CMS Extends Upcoming Two-Midnight Partial Enforcement Delay

by Jacqueline DiChiara

The partial enforcement delay of the two-midnight policy originally set for September 30, 2015 expiration has been extended by the Centers for Medicare & Medicaid Services (CMS) through December 31,...

CMS Proposes Post-SGR Repeal Physician Fee Schedule Update

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has released a projected update to the physician payment schedule. CMS’s proposal marks the first post-Sustainable Growth Rate (SGR) repeal...

Will Voluntary ICD-10 Implementation Reduce Financial Burden?

by Jacqueline DiChiara

Consider the healthcare industry deep in the trenches of an ICD-10 Cinderella effect of sorts. As the ICD-10 implementation clock continues to tick tock, the healthcare industry ruminates and...

Senate Finance Committee, Conway, Address Medicare Spending

by Jacqueline DiChiara

Medicare beneficiaries with chronic conditions will hopefully receive greater assistance due to a new legislative proposal from the Senate Finance Committee. The committee will soon acquire stakeholder...

MACRA Fee Adjustments May Generate Financial Consequence

by Jacqueline DiChiara

Physicians and healthcare providers may endure an even greater financial consequence under the $200 billion Medicare reform package signed by President Obama last week, H.R. 2, the Medicare Access and...

AMA CEO: Flawed SGR No Longer Threatens Payment Delivery

by Jacqueline DiChiara

James L. Madara, MD, Chief Executive Officer and Executive Vice President of the American Medical Association (AMA), provided insight via a morning media conference today on the organization’s...

$100B Aftermath of Medicare Access, CHIP Reauthorization Act

by Jacqueline DiChiara

The ongoing push for value-based reimbursement endures with the finalization of new legislative decisions regarding the permanent SGR repeal's ripple effect on the healthcare industry...

Permanent SGR Repeal, Physician Medicare Fees Overhauled

by Jacqueline DiChiara

The Senate, in conjunction with the House of Representatives, has approved the Sustainable Growth Rate (SGR) repeal to replace it with the Medicare Access and CHIP Reauthorization Act of 2015 (H.R....

Does Missing ICD-10 Delay in SGR Fix Strengthen Healthcare?

by Jacqueline DiChiara

Preceding the Senate’s upcoming vote next week on Monday, April 13 following a two-week hiatus on the Sustainable Growth Rate (SGR) reform bill, H.R.2, the Medicare Access and CHIP Reauthorization...

CMS Delays Two-Midnight Rule, Medicare Claims Now Pending

by Jacqueline DiChiara

The ongoing financial debate between hospitals and physicians about what differentiates an inpatient from an outpatient in terms of administered payment after the stroke of midnight (or...

HIMSS: Providers Awaiting SGR Repeal Seek Interoperability

by Jacqueline DiChiara

Following the House's recent decision to pass the "doc-fix" bill to permanently repeal the sustainable growth rate (SGR) formula by a vote of 392 to 37, the healthcare industry...

SGR Repeal Requires New Focus on Quality Measurement

by Jacqueline DiChiara

In a landslide vote of 392 to 37, the House of Representatives passed legislation last week to permanently repeal the Sustainable Growth Rate (SGR) designed to limit the increase of Medicare physician...

CMS Announces Possible Delay as Medicare Doc Payment Begins

by Jacqueline DiChiara

The Bipartisan Permanent Sustainable Growth Rate (SGR) Fix and Children’s Health Insurance Program (CHIP) Reauthorization Package replaces the flawed Medicare formula as a...

Does the Sustainable Growth Rate Mean Smarter Reimbursement?

by Jacqueline DiChiara

Last week, the House of Representatives passed legislation that permanently repealed the Sustainable Growth Rate (SGR) formula and established an original reimbursement plan with fundamentally...

Bipartisan House Repeals Medicare SGR Before Senate Vote

by Jacqueline DiChiara

There are possible new improvements to the Medicare Sustainable Growth Rate (SGR) payment system today as the bipartisan House of Representatives overwhelmingly passed the Medicare Access and CHIP...