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Tag: Insurance: Medicare

Almost 30 percent of eligible practices failed to register and report data in the first year of the Physician Value-Based Payment Modifier program

Year One Results Out for Value-Based Payment Modifier Program

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Overall, 29.3 percent of eligible practices failed to register and report data and received a penalty
A four-page executive summary of the 2018 final Medicare physician fee schedule that was released by the Centers for Medicare & Medicaid Services has been published by the American Academy of Family Physicians.

AAFP Issues Summary of 2018 Final Medicare Fee Schedule

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Key provisions include 0.3 percent increase in 2018 conversion factor to $35.999
Physicians have two extra weeks to preview their 2016 performance information as a result of a mistake related to the Centers for Medicare &#amp; Medicaid Services' Physician Compare online resource

Doctors Have Extra Two Weeks to Preview Performance Data

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Due to technical issue with Physician Compare, CMS extending time frame for physicians to view data
The Centers for Medicare & Medicaid Services has launched an initiative to examine which provider regulations should be discarded or revamped amid concerns that the regulations are reducing the amount of time that physicians spend with patients

CMS Launches Initiative to Examine Impact of Regulations

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Officials set to travel country gathering information on impact of their regulations on physicians
Transition from a condition-specific to a hospital-wide readmission measure would result in a modest increase in the number of hospitals eligible for readmission penalties and would substantially increase penalties for safety-net hospitals

More Penalties With Hospital-Wide Readmission Measure

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Increase in number of hospitals eligible for penalties, in penalty disparity for safety-net, other hospitals
Much of the total potentially preventable spending for Medicare beneficiaries is concentrated among frail elderly individuals

Potentially Preventable Spending Concentrated in Frail Elderly

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Variation in preventable spending across Medicare subpopulations; 43.9 percent of total in frail elderly
In an effort to restrict daily allowable prescribed dosing of prescription opioids

Medicare Coverage Restrictions for Opioids Rose From ’06 to ’15

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Formularies increasingly using quantity limits and prior authorization to restrict daily allowable dosing
The 2016 Physician Quality Reporting System and the 2016 annual Quality and Resource Use reports have been released for individuals and group practices

2016 Physician Quality Reporting System Reports Available

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Physicians should review reports to know whether they are subject to 2018 PQRS payment adjustment
Medicare paid at least $1.5 billion over a decade to replace seven types of defective heart devices that apparently failed for thousands of patients

Medicare Paid $1.5 Billion to Replace Faulty Heart Devices

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Reasons for replacement included recalls, premature failures, medically necessary upgrades, infections
Prescribing generic drugs for seniors' eye problems could save the U.S. government hundreds of millions of dollars a year

Switching to Generic Eye Meds Could Save Medicare Millions

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Medicare is billed more than $1 billion annually for glaucoma treatments alone, researchers say