Medicare Value-Based Payment and Quality Reporting for Physician Services: Navigating Recent Changes

Leveraging Incentive Payment Opportunities, Avoiding Reimbursement Penalties and the Future of Medicare Fee-for-Service

Recording of a 90-minute CLE webinar with Q&A

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Conducted on Thursday, April 23, 2015

Recorded event now available

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Course Materials

This CLE course will provide guidance to healthcare counsel and reimbursement professionals on the key changes to the CMS Quality Reporting and Incentive Programs and what those changes mean for healthcare providers. The panel will offer best practices for maximizing Medicare reimbursement in a compliant manner and avoiding payment penalties.

Description

In response to rising health care costs and the concern that fee-for-service reimbursement rewards quantity instead of quality, Congress established several programs to reward value and care coordination among providers, including the Physician Quality Reporting System (PQRS), the Value-Based Payment Modifier (VBPM) and the EHR Incentive Program.

It is critical for physicians and other Eligible Professionals to understand the changing reporting requirements for these programs for 2015 to earn incentive payments and avoid Medicare reimbursement penalties.

Congress and the Centers for Medicare & Medicaid Services (CMS) initially made quality reporting voluntary and rewarded Eligible Professionals with incentive dollars for participating in quality reporting programs. This year, however, Eligible Professionals will begin to see reductions to their Medicare reimbursement if they have not elected to participate. These reimbursement penalties will rise to up to 9% of the amount otherwise paid under the Medicare Physician Fee Schedule in 2017 for Eligible Professionals who do not report quality measures and participate in the Medicare EHR Incentive Program this year.

Listen as our authoritative panel of healthcare attorneys examines the 2015 changes to PQRS and VBPM adopted by CMS in the 2015 Medicare Physician Fee Schedule regulations, as well as the 2015 clinical quality measure reporting requirements of the Medicare EHR Incentive Program. The panel will discuss what these changes mean, offer best practices for meeting Medicare’s quality reporting requirements, and provide an outlook on the future of quality data reporting and pay for performance under the traditional Medicare fee-for-service program.

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Outline

  1. Physician Quality Reporting System
  2. Value-Based Payment Modifier
  3. Medicare EHR Incentive Program
  4. Best practices for maximizing reimbursement and avoiding payment penalties
  5. The Future of Medicare Quality Data Reporting and Pay for Performance

Benefits

The panel will review these and other key issues:

  • What are the key changes to the Physician Quality Reporting System? How does CMS measure quality?
  • How does quality tiering determine the type and range of adjustment based on quality and cost measures?
  • What steps can healthcare providers and their counsel take to minimize the likelihood of penalties?

Faculty

Gottlieb, Daniel
Daniel F. Gottlieb
Partner
McDermott Will & Emery

Mr. Gottlieb has extensive experience in advising clients on compliance with federal and state healthcare laws as well...  |  Read More

Scott Weinstein, Esq.
Scott Weinstein, Esq.
McDermott Will & Emery

Mr. Weinstein focuses his practice on general health matters. Prior to joining the firm, he served as a...  |  Read More

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