Proposed Rule from CMS

The Centers for Medicare and Medicaid Services (CMS) has opened registration for a national provider call related to the soon-to-be released 2016 Physician Fee Schedule proposed rule.

MLN Connects® National Provider Call provides will provide an overview of the 2016 Medicare Physician Fee Schedule (PFS) Proposed Rule. The presentation is scheduled to cover proposed updates to the Physician Quality Reporting System (PQRS), Value-Based Payment Modifier (Value Modifier), Electronic Health Record (EHR) Incentive Program, and Comprehensive Primary Care (CPC) Initiative. A question and answer session will follow the presentation.
Although primarily directed at office-based services, this proposed rule may contain provisions directly relevant to therapy and physician services furnished in skilled nursing and assisted living centers under Medicare Part B.

  • Proposed changes to PQRS reporting mechanisms, individual measures, and measures groups for inclusion in 2016
  • Proposed PQRS reporting criteria for Payment Year 2016
  • Criteria for satisfactorily reporting to avoid a PQRS negative payment adjustment and an automatic Value Modifier downward payment adjustment in 2018
  • Certification requirements for reporting electronic clinical quality measures in the Medicare EHR Incentive Program, PQRS, and the CPC Initiative
  • A move towards the Merit-based Incentive Payment System and Alternative Payment Models, based on the amendment of the Medicare Access and CHIP Reauthorization Act of 2015

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