CMS Releases New Payment Rules

November 10, 2014

Categories: Thought Leadership


Center for Medicare & Medicaid ServicesThe Centers for Medicare and Medicaid Services (CMS) recently released final regulations for its fiscal year 2015 Medicare Physician Fee Schedule and the changes include several health IT-related alterations that will affect providers and physicians starting January 1. 

As part of the new rules, CMS announced the creation of a new payment system to support chronic care management, an expansion of covered telehealth services, efforts to combine and streamline payments related to a single patient’s hospital care and the expansion of the Physician Compare website.

The new policies reflect a strategy to promote quality over quantity and find better ways to deliver care, pay providers and distribute information.

According to CMS Administrator Marilyn Tavenner, “These rules are a part of the broader strategy driving greater value in health care…By collaborating and building on best practices across the health care system, we can deliver the results of higher quality care and lower costs that consumers, providers, purchasers, and businesses deserve.”

Industry groups, including the American Telemedicine Association (ATA), weighed in on the new rules and applauded the efforts. In a press release highlighting the news, ATA CEO Jonathan Linkous noted, “Medicare beneficiaries got an important treat for home care of chronic care management, remote patient monitoring of chronic conditions and other services when provided via telehealth…It has been a long time coming, but this rulemaking signals a clear and bold step in the right direction for Medicare” 

CNSI’s Encounter Data Processing System, established for CMS, compliments these new rules to allow the agency to analyze the quality, quantity and kinds of health care services Medicare beneficiaries are receiving within Medicare Advantage (MA) plans. This data determines and updates the risk adjustment factors used in plan payments and models and helps the agency identify trends and make additional policy changes to strengthen the program.

How will the new regulations benefit Medicare and Medicaid recipients? Tweet @CNSICorp to let us know! 

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