CMS

By Jonah Comstock July 11, 2016
CMS has proposed rule changes that would expand the Diabetes Prevention Program effective January 1, 2018. In March, CMS certified that the expansion of the program, including digital versions of the program, would reduce net Medicare spending, these new rules changes, announced last week, are the next concrete steps CMS needs to take to make the DPP reimburseable.  “Today's proposals are...
By Jonah Comstock May 31, 2016
When the Center for Medicare and Medicaid Services announced its new Comprehensive Primary Care Plus (CPC+) payment model, the announcement was mired by protestations from prominent investor and Venrock partner and former White House policy advisor Dr. Bob Kocher and former National Coordinator for Health IT Dr. Farzad Mostashari, who called out CMS for excluding ACOs from the initiative. On...
By Jonah Comstock May 10, 2016
Amino, a San Francisco-based startup that uses claims data to help consumers choose a doctor, announced today that it now has access to Medicare claims data and has been certified by the Centers for Medicare and Medicaid Services to create new healthcare quality measures focused on the healthcare consumer experience. The company uses a database of billions of patient-doctor interactions to match...
By Jonah Comstock April 26, 2016
The Center for Medicare and Medicaid Services released its 1,425-page Managed Care Final Rule, a long-awaited update to CMS bylaws which, according to CMS, “aligns key rules with those of other health insurance coverage programs, modernizes how states purchase managed care for beneficiaries, and strengthens the consumer experience and key consumer protections.” In part, the rule opens the door...
By Jonah Comstock April 12, 2016
CMS has announced a new expanded initiative for bringing value-based repayment to primary care. The Comprehensive Primary Care Plus (CPC+) program, builds on the Comprehensive Primary Care program introduced in 2012, but will expand the program to a larger number of practices and includes some tweaks to the model.  “Strengthening primary care is critical to an effective health care system,” said...
By Jonah Comstock January 28, 2016
The Centers for Medicare and Medicaid Services came out with a final rule yesterday that would require face-to-face visits prior to home health services for Medicaid patients, a rule that already exists for Medicare patients. But, as Politico spotted, the rule also includes a parenthetical allowing those "face-to-face" visits to be conducted via telehealth. Exactly what constitutes telehealth isn...
By Jonah Comstock December 14, 2015
All but eight states introduced at least one bill related to telemedicine to their state legislature in 2015, according to a new report from the National Conference of State Legislatures. State lawmakers floated a total of 200 bills across the country.   The report is meant to explore the benefits and risks of telehealth for state legislatures, as well as to provide an overview of the status of...
By Brian Dolan July 2, 2015
At the beginning of 2015, CMS began reimbursing physicians for the care they provide to a particular group of their Medicare patients remotely and between visits. This new billing code, called Chronic Care Management (CCM), required that this remote care meet a few criteria, like patients must have two or more chronic conditions; the physician must establish a comprehensive care plan for the...
By Aditi Pai April 8, 2015
A few months ago, Accenture reported that 19 of the 25 states developing state health innovation plans (SHIPs) were planning to invest more in telehealth this year. Now, the Office of the National Coordinator for Health Information Technology (ONC) has published online resources to help the states that are participating in the State Innovation Models initiative make better use of digital health...
By Jonah Comstock March 23, 2015
Last week, the Centers for Medicaid and Medicare Services (CMS) announced the long-awaited proposed guidelines for Stage 3 of Meaningful Use requirements for electronic health records. On the same day, the Office of the National Coordinator for Health IT (ONC) released the proposed 2015 certification criteria for EHRs. The standards proposed will be optional through 2017 and mandatory for all...

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