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Specialists Notch Victory in New CMS Rule on Quality Reporting
Medicare has agreed to allow specialist medical societies to determine the quality measures physicians will report when the new reporting system goes into effect on Jan. 1.
Medicare has agreed to allow specialist medical societies to determine the quality measures physicians will report when the new reporting system goes into effect on Jan. 1.
The rule represents a major victory for the specialty societies, which had protested a common set of quality measures that many said favored primary care and family physicians over specialists. CMS in 2015 will begin imposing penalties on physicians who fail to report to one of these new "qualified clinical directories," which will satisfy requirements for participating in the agency's Physician Quality Reporting System.
Dr. Arthur Lerner, with Palm City, Fla.-based Technology Education Consulting in Healthcare, said the new rule creates more incentive for specialists to participate in PQRS and opportunities for them “to take control of the process”—a process that he said is currently geared toward only primary-care doctors.
Read the full story here: http://bit.ly/1hA2780
Source: Modern Healthcare
What's at Stake as Oral Arguments Are Presented in the Braidwood Case? Q&A With Richard Hughes IV
April 21st 2025Richard Hughes IV, JD, MPH, spoke about the upcoming oral arguments to be presented to the Supreme Court regarding the Braidwood case, which would determine how preventive services are guaranteed insurance coverage.
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Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Comparing Breast Cancer Treatment Outcomes Between Fee-for-Service and Medicare Advantage
April 4th 2025This study examined postdiagnosis breast cancer treatment outcomes for Medicare Advantage vs fee-for-service (FFS) Medicare in Ohio and found no significant differences overall but disparities for Black patients with FFS Medicare.
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