Podcast appearances and mentions of chip reauthorization act

Web: www.JonesHealthLaw.com Phone: (305)877-5054 Instagram: @JonesHealthLaw Facebook: @JonesHealthLaw YouTube: @JonesHealthLaw The Merit-Based Incentive Payment System (“MIPS”) established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), came into effect on January 1, 2017. The MIPS program was designed to adjust Medicare payments based on clinical performance. MIPS only applies to eligible professionals whose practice caters to Medicare Part B beneficiaries. MIPS evaluates the clinical performance of eligible professionals using a composite performance score, comparing performance on a measure to measure benchmark. The results indicate whether the eligible professional will receive a decrease, an increase, or the same Medicare reimbursement for Part B claims. --- Support this podcast: https://podcasters.spotify.com/pod/show/joneshealthlaw/support

Only here on Talk Ten Tuesdays will you learn the whole story behind the latest request from the Centers for Medicare & Medicaid Services (CMS). The agency is asking for feedback on four cost-efficiency models as part of the Merit-Based Incentive Payment System (MIPS) program. The deadline is fast approaching: March 25, 2022. The proposed cost-efficiency models for the CY 2023 MIPS cover positions including emergency physician, psychiatrist, and cardiologist/hospitalist.  During the next live broadcast, CDI physician expert Dr. James S. Kennedy of CDIMD in Nashville, Tenn. will report on CMS's proposed implementation of these cost-efficiency models, which will be effective Jan. 1, 2023, as authorized by the Medicare and CHIP Reauthorization Act of 2015 (MACRA) – as well as the role CDI teams have in ensuring success in avoiding physician financial penalties of up to 2.7 percent.The live broadcast will also feature these other segments: Coding Report: Coordination and Maintenance Committee Meeting: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC will file two reports on the Coordination and Maintenance Committee (C&M) meeting that will be underway at the time of this broadcast from CMS headquarters in Baltimore. Johnson will also file a follow-up report on the C&M meeting at the conclusion of the broadcast. Tuesday Focus: Continuous Glucose Monitoring: Susan Gatehouse, founder and CEO for Axea Solutions, will report on continuous glucose monitoring (CGM) systems, designed to improve the ability to treat and manage diabetes using everyday technology. However, is the coding for the treatment and management of diabetes adequately captured? News Desk: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will anchor the Talk-Ten-Tuesdays News Desk.TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment. 

Dr. Jeff Bailet is president and chief executive officer of Altais, a subsidiary of Blue Shield of California. Altais was formed to help physicians and their practices reduce administrative burden, spend more time with patients, and improve access to quality, affordable health care. Dr. Bailet has more than 25 years of healthcare leadership experience having served as executive vice president of Blue Shield of California's Health Care Quality and Affordability division, executive vice president at Aurora Health Care and President of Aurora Health Care Medical Group and CMO of PacMed Clinics, a multispecialty medical group in Seattle. He also currently chairs the federal Physician-Focused Payment Model Technical Advisory Committee (PTAC), established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Like me, he's a board-certified otolaryngologist having completed residency at UCLA and holds a master of science with concentration in Environmental Health. Given his breadth of leadership experience, we discuss how he arrived there, advice he'd give up and comers and then broader questions like where he'd like to see change about the US healthcare system and why physicians need a seat at the table. We also talk about trends physician practices, why smaller practices are good for patients, and what to look for if you're considering merging with a larger practice or selling your practice. As a physician, you routinely check your patients' health. But when was the last time you checked the financial health of your practice? Request your free revenue cycle assessment and learn more from today's sponsor, CareCloud, at www.doctorpodcastnetwork.com/carecloud

On this episode of The Dish on Health IT, Alix Goss vice president and senior consultant at Imprado joins our hosts Ken Kleinberg, Pooja Babbrah and Jocelyn Keegan to talk historical policy and standards milestones, how they brought us to where we are today and why it's important for the industry to go above and beyond the mentality of just checking the box for policy adherence in order to gain a competitive advantage and achieve better patient outcomes. Kens asks Alix to give us a breakdown of how we got to where we are today in health IT. Alix kicks off the podcast by explaining that for several decades, we've been trying to address improved affordability and outcomes in our healthcare system. It's about the right data at the right time for the right patient and in the right format. In 1996, under the Health Insurance Portability and Accountability Act, we set off on a journey that forced us to be on a trajectory, as a nation, in our information exchange for administrative simplification. Think of that as governing, or establishing, pharmacy and medical standards along the way, in the 1999 to 2003 timeframe.Then, we rolled up our sleeves and tried to make all of that work only to realize we really needed to bring clinical aspects into it too. We started working on the American Health Information Community (AHIC) under the Bush administration, which helped us figure out what clinical data exchange needed to look like. A lot of the work was memorialized under the Health Information Technology and Economic and Clinical Health Act (HITECH) of 2009. Shortly after, we got the Affordable Care Act. Then came the Medicare Access and CHIP Reauthorization Act of 2015, which established a robust Quality Payment Program, changing the way Medicare rewards for clinical value over volume. Most recently, our journey continued with the 21st Century Cures Act in 2016, which promotes and funds the acceleration of research and drug and medical device development. In the end, HIPAA gave us administration simplification and now 21st Century Cures is bookending decades of progress and forcing us into this intersection of clinical administrative data all around the patient.Ken asks Alix if she believes Fast Healthcare Interoperability Resources (FHIR) application programming interfaces (APIs) and rated standards are innovative. She responds with a question. What is your definition of innovation? If you're in other industries you're probably thinking, yeah, not so much. But for healthcare, we're so complex with the variability of all the data elements. Our current transaction evolution to adopt FHIR will provide us with greater flexibility throughout the entire process. Alix thinks FHIR is the way we're going to bridge a great deal of problems, but she does not necessarily see electronic data interchange (EDI) going away. It's gotten into the DNA of our architectures and our business decisions. It's the way we do things. We like to adopt new standards, but where we always fall short is doing the cultural transformation of workflows as opposed to sometimes just having a “check the box” mentality.Jocelyn, who has extensive FHIR Accelerator experience, notes it is no longer just about the rules or the laws that have gone into effect, it really has to do with if we're not figuring out how to make value-based care work, what is our alternative? What will push people to make the shift? The pandemic further exposed current weaknesses in our ability to exchange clinical data, to let us roll out vaccines at scale across our public health infrastructure. There could not be a more compelling business case for why it's so imperative for everyone to start picking up existing tools and implementing. As data starts to free and more players implement, those that don't react or those that have the “check the box” mentality are going to put themselves in a significant competitive disadvantage in the coming years.Pooja has examined these issues from a patient, CARIN Alliance perspective. She is concerned with how we make it easier for patients to access and share their data. FHIR APIs finally get us to that point where it's easier for patients to download their data. We're getting to the point, thanks to some of the recent technology and standards, where it is easier for patients and consumers to download their information and to do searches on price transparency. Ken moves the conversation to payers. He asks Alix if this stakeholder group is embracing change or just “checking the box”. Alix says it is a very mixed landscape out there as far as opinions and corresponding strategies. There are some who are only going to come along when the axe (aka penalties) comes down. Then there are others who are pushing the envelope and pulling folks along. Alix thinks there is a landscape in the payer community that feels overburdened and has its own compliance fatigue. She believes there is also skepticism around what might change. That skepticism coupled with longer term trust dynamics in the payer-provider community plus the sustainability themes for payers (rapidly changing business models) has caused them to start considering things with different lenses that they've never had to before. Past approaches have trained the industry to wait for regulations and incentives to create movement, meaning there is far more “check the box” mentality than anything. Alix is optimistic though, especially under the FHIR Accelerator community, that there is a group of thought leaders who are leaning in and trying to drive a stronger course forward for us all.Ken asks Jocelyn what her comments are about payers being burdened. She notes it is a fair point and that there a couple of factors at play here. To Alix's point, there's a lot of entrenched operational support and infrastructure in place that's been running to support EDI for a number of years, and there has been minimal effort in doing clinical data exchange with payers. Because of the historical combative relationship between payers and providers, we haven't seen much progression yet. However, with the Da Vinci Project, we get to see daily how those relationships are changing. Payers who leverage modern APIs will transform their organizations, how they work and how they view their relationships with provider partners. They will be the ones who come through the curve faster.Pooja notes we are essentially flipping the entire model payers are operating under today. They're not used to opening up their data to others. It's the same in the PBM space. On the pharmacy side, we're not quite there yet but how do we make it easier for data to be shared? How do we make it easier for patients to access their data?Pooja also brings up that payers are having to meet interoperability, patient access and price transparency rules, which is a lot. She has a feeling payers might default to just “checking the box” because they will all be in a rush to meet what's in place today. The point is though, we need people to be thinking outside of “checking the box”. Where can they focus? What are the specific use cases that they could look to in order to achieve a market advantage? Pooja thinks that's where payers need to be paying attention.Alix comments that we're not just transforming standards, we're transforming culture. How does a patient become informed? We have an educational foundation here of using technology to interpret information in collaboration with someone's payers, providers, benefit plans and their family's budget. That's how we stitch this all together. However, to Pooja's point, the history of payers and the cultural transformation is one of our shortcomings in implementation efforts that we've undertaken in the last 30 years.Ken asks Alix how she sees the new federal administration playing out over the next few years. Alix says public infrastructure has been duct taped together and underfunded for decades. The work people have done at a local and state level in partnership with the Centers for Disease Control and Prevention (CDC) has been amazing. It is also amazing how the commercial sector relies on registry and public health information. So many use the data, yet very few people help support the public health infrastructure. So, Alix thinks we are going to see a lot of transformation in the public health space (for the good). Having a new national coordinator like Micky Tripathi is going to really help leverage implementation efforts and take us to the next round of progress. Additionally, Alix does see FHIR as a key factor in bridging a number of issues out there, but she's not expecting a hard left turn in this next administration.Ken asks Alix for her final thoughts. Alix stresses for people to get educated and involved in standards development, both policy and technology standards. If you can't play at the national level directly, you can always offer your public comment on proposed rulemaking. We all have experiences to share and we all should exercise our voice to strengthen our nation's trajectory and agility to respond to all the amazing technology and medical advances that are yet to come. So if you can't get involved directly, tap into the expertise of the folks at Point-of-Care Partners or Imprado because they can inject that knowledge and add your story to their library of perspectives from which we influence.

Dr. Steven Flanagan is Howard A. Rusk Professor of Rehabilitation Medicine and Chairperson of the Department of Rehabilitation Medicine at NYU Langone Health. He joined NYU Langone Medical Center in 2008 as Professor and Chairman of Rehabilitation Medicine and Medical Director of Rusk Rehabilitation after serving as Vice Chairman of Rehabilitation Medicine at Mount Sinai School of Medicine. He serves on numerous medical advisory boards and is a peer reviewer for several scientific journals. He has authored numerous chapters and peer-reviewed publications, and has participated in both federally- and industry-sponsored research. His medical degree is from the University of Medicine & Dentistry of New Jersey and he completed his residency at Mt. Sinai Medical Center/Cabrini, Rehabilitation Medicine. PART 1 In Part 1 of his presentation, Dr. Flanagan discussed the value that physical medicine and rehabilitation (PM&R) add to health care.His objective in this session is to give an overview of health care reform and its impact on PM&R. Many changes have occurred since he began practicing medicine three decades ago. Health care reform is real. From 1960 to 2010, wages and GDP increased, but nowhere close to the enormous rise in health care expenditures, which are not sustainable. Also, we no longer can claim that we have the best health outcomes compared to other nations. Recognizing that health spending could no longer continue at such a rapid pace, the government came up with something called the Sustainable Growth Rate (SGR) to limit the outlandish expansion of health care costs. The attempt never achieved what was intended and Congress terminated the SGR in 2015. It was replaced by MACRA, the Medicare Access and CHIP Reauthorization Act of 2015, which redefined how physicians would be reimbursed and it is based on quality measures that they would have to meet. The objective is to achieve the triple aim of health care reform: improve health care quality, produce better outcomes, and improve the patient experience. A quadruple aim includes improving the satisfaction of providers. He indicated that management of post-acute care is of importance and that PM&R is uniquely situated to be involved in achieving the triple aim.  It can do so by focusing on patient-centered coordinated care that is comprehensive across the entire continuum. PART 2  Listeners to Part 1 of Dr. Flanagan’s presentation may recall that he discussed health reform efforts to control health care costs and how the provision of physical medicine and rehabilitation (PM&R) services has a unique role to play in achieving health reform’s triple aim. In Part 2, his comments had a focus on intensive care unit patients, a group associated with large health care costs and one not usually associated with the provision of rehabilitation services. What about safety? It’s feasible, but is it wise? Should we get folks up and walking who are so critically ill? Aren’t we putting them at risk of all sorts of bad things from happening? It is safe and the outcomes are fine and there is research to prove it. We are enhancing mobility, decreasing the number of days patients are on ventilators, and in some cases, not only are we not causing worse mortality, we are decreasing mortality. If you are doing all of this, the last question is what about costs? Despite increasing the use of PT, OT, and Speech staff, by getting patients out of the hospital faster, there is a cost savings. A pilot study was done at NYU to look at what happens to patients after they left the hospital to see if there were any additional savings. The results show that it was possible to reduce hospitalization, reduce the average direct cost per day, and there was a significant increase in the proportion of patients who were discharged to the community with no services at all. The latter outcome represented an overall cost savings for the health system. He also provided information about something that is relatively new and what they are working on at NYU, which is site neutral payments. A question and answer period followed his presentation.

Dr. Steven Flanagan is Howard A. Rusk Professor of Rehabilitation Medicine and Chairperson of the Department of Rehabilitation Medicine at NYU Langone Health. He joined NYU Langone Medical Center in 2008 as Professor and Chairman of Rehabilitation Medicine and Medical Director of Rusk Rehabilitation after serving as Vice Chairman of Rehabilitation Medicine at Mount Sinai School of Medicine. He serves on numerous medical advisory boards and is a peer reviewer for several scientific journals. He has authored numerous chapters and peer-reviewed publications, and has participated in both federally- and industry-sponsored research. His medical degree is from the University of Medicine & Dentistry of New Jersey and he completed his residency at Mt. Sinai Medical Center/Cabrini, Rehabilitation Medicine. PART 1 In Part 1 of his presentation, Dr. Flanagan discussed the value that physical medicine and rehabilitation (PM&R) add to health care.His objective in this session is to give an overview of health care reform and its impact on PM&R. Many changes have occurred since he began practicing medicine three decades ago. Health care reform is real. From 1960 to 2010, wages and GDP increased, but nowhere close to the enormous rise in health care expenditures, which are not sustainable. Also, we no longer can claim that we have the best health outcomes compared to other nations. Recognizing that health spending could no longer continue at such a rapid pace, the government came up with something called the Sustainable Growth Rate (SGR) to limit the outlandish expansion of health care costs. The attempt never achieved what was intended and Congress terminated the SGR in 2015. It was replaced by MACRA, the Medicare Access and CHIP Reauthorization Act of 2015, which redefined how physicians would be reimbursed and it is based on quality measures that they would have to meet. The objective is to achieve the triple aim of health care reform: improve health care quality, produce better outcomes, and improve the patient experience. A quadruple aim includes improving the satisfaction of providers. He indicated that management of post-acute care is of importance and that PM&R is uniquely situated to be involved in achieving the triple aim.  It can do so by focusing on patient-centered coordinated care that is comprehensive across the entire continuum. PART 2  Listeners to Part 1 of Dr. Flanagan’s presentation may recall that he discussed health reform efforts to control health care costs and how the provision of physical medicine and rehabilitation (PM&R) services has a unique role to play in achieving health reform’s triple aim. In Part 2, his comments had a focus on intensive care unit patients, a group associated with large health care costs and one not usually associated with the provision of rehabilitation services. What about safety? It’s feasible, but is it wise? Should we get folks up and walking who are so critically ill? Aren’t we putting them at risk of all sorts of bad things from happening? It is safe and the outcomes are fine and there is research to prove it. We are enhancing mobility, decreasing the number of days patients are on ventilators, and in some cases, not only are we not causing worse mortality, we are decreasing mortality. If you are doing all of this, the last question is what about costs? Despite increasing the use of PT, OT, and Speech staff, by getting patients out of the hospital faster, there is a cost savings. A pilot study was done at NYU to look at what happens to patients after they left the hospital to see if there were any additional savings. The results show that it was possible to reduce hospitalization, reduce the average direct cost per day, and there was a significant increase in the proportion of patients who were discharged to the community with no services at all. The latter outcome represented an overall cost savings for the health system. He also provided information about something that is relatively new and what they are working on at NYU, which is site neutral payments. A question and answer period followed his presentation.

In this episode, Adaeze Enekwechi, PhD, MPP, President at IMPAQ joins the show to discuss the importance of lived experience when talking about social determinants of health. We discuss government programs and policies that challenge SDoH, innovative solutions that stand out, and where we're headed as an industry. To connect with Adaeze: LinkedIn: https://www.linkedin.com/in/adaeze-enekwechi-phd/ Read Adaeze's article in Health Affairs: "It’s Time To Address the Role of Implicit Bias Within Health Care Delivery.” Dr. Adaeze Enekwechi is the President of IMPAQ, a 400 person policy research and analytics firm that comprises three entities: IMPAQ International, a public policy research and analytics firm; Maher & Maher, a learning solutions provider; and ASCEND, a technology and information product company. Dr. Enekwechi provides strategic oversight of all research, technical assistance, and technology services across all policy and program areas, including health care, workforce development, social programs, and international development. Prior to joining IMPAQ, Dr. Enekwechi served as Vice President for Policy, Strategy, and Analytics with a consulting firm. She also served as the Associate Director for Health Programs at the White House Office of Management and Budget (OMB) under President Obama. As the Federal government's chief health care budget official, she provided policy, management, and regulatory oversight for over $1 trillion in spending on a range of Federal programs, including the Centers for Medicare & Medicaid Services, Centers for Disease Control and Prevention, the National Institutes of Health, and all Federal health agencies. At the OMB, Dr. Enekwechi managed the review and approval of all major Center for Medicare & Medicaid Innovation reform proposals, Medicare Access and CHIP Reauthorization Act of 2015/Quality Payment Program rulemaking, and many Food and Drug Administration policies, Medicaid negotiations, Zika, and other public health funding requests. Dr. Enekwechi is highly experienced with the Affordable Care Act (ACA) implementation, playing a key role in driving ACA budget, policy, strategy, and operational coordination with various agencies, including the Department of Treasury, the Internal Revenue Service, and the Office of Personnel Management, among others. Dr. Enekwechi completed a BA at the University of Iowa, an MPP at the American University, and a PhD in Health Services and Policy from the University of Iowa. Her research area covers social determinants of health, long-term care, and evidence based policymaking. Dr. Enekwechi is a Research Associate Professor of Health Policy and Management at the Milken Institute School of Public Health at the George Washington University and was a Visiting Professor at Meharry Medical College in Nashville, TN. Her teaching focuses on Federal health policy, the US health care infrastructure, health equity, and evidence-based policymaking. She also serves on the boards of directors and advisors for a number of health care organizations.

  Craig covers upcoming Medicare regulation and legislation insurance agents need to know about in 2020! Learn about the implications of MACRA, the 21st Century Cures Act, the 2021 Advance Notice, and more, and what it means for your insurance business.   Ritter’s State of the Senior Market – Watch the videos at ritterim.com/sotsm   Register for Craig Ritter’s Live Q&A on March 26th at 2PM ET http://bit.ly/385cj51    State of the Senior Market Video Schedule:   February 25, 2020 – Coming Soon: Ritter’s State of the Senior Market | TrailerMarch 3, 2020 – The Year in Review | Episode 1March 10, 2020 – Medicare Regulation & Legislation | Episode 2March 17, 2020 – Enrollment Stats for 2020 | Episode 3March 24, 2020 – Major Industry Trends | Episode 4March 26, 2020 – Live Q&A with Craig Ritter   State of the Senior Market Podcast Episodes:   A Word from Our President, Craig Ritter | State of the Senior Market 2020 The Year in Review | State of the Senior Market 2020 Episode 1 Medicare Regulation & Legislation | State of the Senior Market 2020 Episode 2 Enrollment Stats for 2020 | State of the Senior Market 20202 Episode 3 Major Industry Trends | State of the Senior Market 2020 Episode 4 Q&A with Craig Ritter | State of the Senior Market 2020   Mentioned in this episode:   CMS: Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) FDA: 20th Century Cures Act Learn more about Medicareful Medicare and Medicaid Programs: Contract Year 2021 and 2022 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescriptions Drug Benefit Program, Medicaid Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly Medicareful Living Blog Register with Ritter Ritter Insurance Marketing Website The Ritter Platform   More episodes you’ll like:   March 13, 2020 | The Friday Five The Friday Five for March 13, 2020: CVS Pharmacy drops delivery fees during Coronavirus outbreak; Coronavirus Q&A from CNN; Jack Dorsey still CEO of Twitter; oil wars and gas prices; and PepsiCo buys Rockstar Energy. 4 Reasons Why Ritter Should Be Your FMO Insurance Agency Looking for an FMO? Not sure what a field marketing organization like Ritter Insurance Marketing can do for your insurance business? Learn everything you need to know in this can’t-miss episode of the ASG Podcast! 5 Out-of-the-Box Ideas for Selling Final Expense Insurance Pitching final expense insurance may seem challenging, but it doesn't have to be! We’ve got five concepts to work into your presentation strategy before your next sales appointment!  FAQs About Working with Ritter Insurance Marketing Have questions about partnering with Ritter Insurance Marketing? Not sure what a field marketing organization is, or how joining one can help your insurance business? Curious about lead programs, CE credits, and other opportunities FMOs like Ritter have to offer? We talk with our sales team to answer common questions about working with FMOs and more! What Is E&O Insurance and Do You Need It? You've worked hard to create and grow your insurance business — but how do you protect your investment? Even insurance agents need protection. In this episode, we make the case for errors and omissions (E&O) insurance.   The latest from Ritter’s Blog:   The Best Software for Tracking Your Medicare Commissions You may enjoy selling Medicare Advantage, Medicare Supplement, and Part D plans because you like helping others, but you and your family may also depend on the commissions your insurance career or side hustle… (read more) Examining the Medicare Part B Premium Giveback The standard monthly Part B premium cost for beneficiaries in 2020 is $144.60. Wouldn’t it be nice if your clients could get some of that money back? Good news, this is a possibility...(read more) The Top 5 Products to Sell During Medicare's Lock-In Period Which products should a Medicare sales agent sell outside of the Annual Enrollment Period to keep earning commissions? We’ve got the top five additional plan types that should be a part of an agent’s portfolio during the... (read more)   Subscribe & Follow:   Apple Podcasts Google Podcasts Overcast Podbean Spotify Stitcher   Connect on social:   Facebook Twitter YouTube LinkedIn  

This week, Ted Long, the VP for Primary Care at NYC Health + Hospitals joins us to talk about how we can make primary care better for patients and for physicians at various levels of scale. He previously served as the Senior Medical Officer for the Quality Measurement and Value-Based Incentives Group at the Centers for Medicare and Medicaid Services, which covers over 20 federal programs including the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the Hospital Readmission Reduction Program, and the Hospital Value-Based Purchasing Program. Earlier, he served as Medical Director at the Rhode Island State Department of Health. He is a practicing primary care physician and is also on the faculty at the Harvard Medical School Center for Primary Care. We love to hear from our listeners, so please tweet us @RoSPodcast or @HMSPrimaryCare, or send us an email with comments and suggestions at contact@rospod.org. Thanks for listening!

Returning guest, Vanessa Rose Bisceglie, discusses the new law changes within MACRA (Medicare Access and CHIP Reauthorization Act of 2015) and how physicians can stay in compliance and earn the highest bonus in their medicare payment. She also discusses the telehealth care management services that they offer that assists patients between office visits. Visit www.hpr.fm to listen to more health-related podcast episodes.

On this episode of ACEP's "Frontline", host Dr. Ryan Stanton talks to Dr. Jennifer Wiler about Alternative Payment Models. Do you know what “Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)” is? It’s potentially the most important piece of legislation passed in this decade which is going to change the way physicians and clinicians are paid. Listen in to find out how this impacts Emergency Physicians and how can you help shape these models.

Dr. Mac Knight and Brandt Jewell join Mark to discuss preparing a physician practice for MACRA participation. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) becomes effective January 1, 2019. Episode Synopsis Mark, Dr. Knight and Brandt discuss how MACRA and other pay for performance reimbursement models are shaping the healthcare industry and how these changes are affecting the physician practice. They explain key data points to review while preparing for the changes to reimbursement on January 1, 2019. They also present different types of costs to consider in concert with reviewing past quality data to evaluate a practice’s return on investment when participating in MACRA. Extras White Paper: Preparing a Physician Practice for MACRA Participation MACRA Implementation: Have you Established a Plan to Succeed? Making the Most of Your MACRA Reporting Follow Dr. Knight on Twitter Connect with Dr. Knight on LinkedIn Follow Brandt on Twitter Connect with Brandt on LinkedIn Contact Information Subscribe to our feed in Apple Podcasts, Google Podcasts, Google Play, Spotify, or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know! We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues in which you have an interest. You can also provide recommendations on topics for future episodes.  Email us: feedback@cokergroup.com Follow us on Twitter: @cokergroup Connect with us on LinkedIn: Coker Group Company Page

In this CAPcast, Dr. Diana Cardona discusses what pathologists need to know about the Medicare Access and CHIP Reauthorization Act of 2015, also known as MACRA. Dr. Cardona, the Medical Director of the Surgical Pathology and Immunopathology Laboratories at Duke University Medical Center, is teaching a course on this topic with Dr. Stephen Black-Schaffer at CAP18 in Chicago, which will be held Oct. 20-24: www.capannualmeeting.org.

Listen NowThis past November 16 CMS published the agency's final 2018 MACRA (Medicare Access and CHIP Reauthorization Act) rule (at 661 federal register pages).  MACRA, authorized in 2015, formulates how approximately 1.5 million Medicare Part B physicians and other eligible clinicians are reimbursed.  Annual MACRA proposed and final rule making is closely monitored since the law's MIPS (Merit-Based Incentive Payment System) and Advanced Payment Model (APM) pathway are the two formulas CMS uses to annually update Fee for Service Medicare Spending (Part A and Part B) and how eligible clinicians under Medicare Advantage (Part C) can participate in MACRA's payment updates or rewards.    During this 24 minute conversation Ms. O'Brien discusses the MIPS two threshold exclusions, MIPS quality and cost components, the composite performance score (CPS), the Advanced APM (AAPM) pathway, the anticipated 2018 Medicare Advantage (MA) AAPM demonstration and criticisms of MACRA implementation, specifically MedPAC's.  Ms. Kristen O'Brien serves as Counsel at the law firm, Olsson, Frank and Weeda (OFW), in their Health Industry and Regulatory Practice.  Prior to OFW, she served as Senior Legislative Counsel with the American Medical Association and prior still worked in private practice.   Ms. O'Brien's experience also includes serving as professional staff for the Senate Finance Committee under Former Committee Chair, Senator Max Baucus (D-MT), where she worked on health and environmental issues as well as financial reform.  Ms. O'Brien received her J.D. cum laude from Georgetown University Law Center and her undergraduate from Cornell University that included study at the London School of Economics.The 2018 final MACRA rule is at: https://www.federalregister.gov/documents/2017/11/16/2017-24067/medicare-program-cy-2018-updates-to-the-quality-payment-program-and-quality-payment-program-extreme. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

The complexity of alternative payment models requires routine assessments. We discuss the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and discuss Merit-Based Incentive Payment Systems (MIPS).

What’s it like working for President Trump after working for President Obama? Former White House policy advisor Maya Uppaluru speaks to the energy of both white houses, the initiatives that persist despite the new President, and what it’s like to be a working mom in these roles… Maya Uppaluru was a policy advisor in both the President Obama White House and President Trump White House.  Maya joined the White House in 2015, in the Office of Science and Technology Policy, launching the Precision Medicine Initiative and serving as a policy advisor to the U.S. Chief Technology Officer, where she helped to shape national policies around health data interoperability and led public-private collaborations to facilitate better access to health data for medical research. She is now an associate in Crowell & Moring’s Washington, D.C. office with the Digital Health Practice and Health Care Group and provides strategic, legal, and regulatory advice to a range of organizations at the forefront of health innovation, including providers, plans, large tech companies, startups, and venture capital. Maya has a track record of helping technologists successfully navigate complex regulations to achieve their design and product goals. Most recently, she was on the healthcare team at the United States Digital Service, which aims to improve the way government delivers services to the American people through better technology and user-centered design. Mayaworked directly with engineers, data scientists, designers, and product managers on the launch of the All of Us Research Program at the National Institutes of Health. She also worked with the Centers for Medicare and Medicaid Services to improve data sharing with physicians participating in the Quality Payment Program, and transition Medicare from fee for service to value-based care under the Medicare Access and CHIP Reauthorization Act. Previously, Maya served as a policy advisor at the Office of the National Coordinator for Health IT, where she drafted regulations pertaining to patient access to health data and application programming interfaces and created the first program to link health IT policymakers directly with digital health startups and the venture capital community. Maya also served as an attorney advisor for the Healthcare Connect Fund at the Federal Communications Commission, working to expand access to broadband for rural health care providers to gain access to technology, including telemedicine and electronic health records.

This week, the Senate released its healthcare bill; CMS proposed changes to the implementation of the Medicare Access and CHIP Reauthorization Act; a study found Medicaid expansion increased emergency department utilization, but more people had insurance coverage; and another diabetes drug received a new cardiovascular indication.

As critical access hospitals (CAHs) and small rural hospitals evaluate whether to participate in an alternative payment model (APM) as an option under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) for their medical providers, it is important for hospital leadership to evaluate the APM model from a business plan perspective. The APM model requires hospital and clinician integration which will impact reimbursement and how care is coordinated and managed in the both the hospital and practice setting. Pat Schou, Executive Director for the Illinois Rural Community Care Organization (IRCCO), a statewide rural accountable care organization (ACO), discusses the financial strategies IRCCO has undertaken to prepare hospitals and their medical providers for clinical integration. She shares how they measure the return on investment for the ACO as well as for the hospital and medical provider. Ms. Schou explains the advantages and disadvantages of an organization considering becoming a part of an APM. View the slides: https://www.ruralcenter.org/events/alternative-payment-models-business-perspective   Speaker:  Pat Schou, Executive Director, Illinois Critical Access Hospital Network and Illinois Rural Community Care Organization

In this episode on the Medicare Access and CHIP Reauthorization Act, American Society of Ophthalmic Administrators president Bill Koch, COE, CPC, COA, interviews Nancey McCann, director of government relations for the American Society of Cataract and Refractive Surgery to get a better understanding of the Merit-based Incentive Payment System (MIPS) and learn how practices and physicians will be evaluated and scored in 2017 which will effect 2019 payments.

Host: Matt Birnholz, MD The new Quality Payment Program, QPP, created by Medicare Access and CHIP Reauthorization Act, or MACRA, has generated questions from the physician community regarding how to participate, and what that participation will mean for benefiting practices. On this episode, we'll investigate physician-focused alternative payment models, or APMs, and their emerging role in this new Quality Payment Program. Host Dr. Matt Birnholz welcomes Sandy Marks, Assistant Director of Federal Affairs at the American Medical Association to discuss APMs.

Host: Matt Birnholz, MD The new Quality Payment Program, QPP, created by Medicare Access and CHIP Reauthorization Act, or MACRA, has generated questions from the physician community regarding how to participate, and what that participation will mean for benefiting practices. On this episode, we’ll investigate physician-focused alternative payment models, or APMs, and their emerging role in this new Quality Payment Program. Host Dr. Matt Birnholz welcomes Sandy Marks, Assistant Director of Federal Affairs at the American Medical Association to discuss APMs.

This is the third segment in a three-part series about the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Speaker: Steven G. Pine

Host: Matt Birnholz, MD The new Quality Payment Program, QPP, created by Medicare Access and CHIP Reauthorization Act, or MACRA, has generated questions from the physician community regarding how to participate, and what that participation will mean for benefiting practices. On this episode, we’ll investigate physician-focused alternative payment models, or APMs, and their emerging role in this new Quality Payment Program. Host Dr. Matt Birnholz welcomes Sandy Marks, Assistant Director of Federal Affairs at the American Medical Association to discuss APMs.

Host: Matt Birnholz, MD The new Quality Payment Program, QPP, created by Medicare Access and CHIP Reauthorization Act, or MACRA, has generated questions from the physician community regarding how to participate, and what that participation will mean for benefiting practices. On this episode, we’ll investigate physician-focused alternative payment models, or APMs, and their emerging role in this new Quality Payment Program. Host Dr. Matt Birnholz welcomes Sandy Marks, Assistant Director of Federal Affairs at the American Medical Association to discuss APMs.

Listen NowOver approximately the past decade the health care industry has become increasingly committed to financially incenting physicians and other clinicians, or tying performance to reimbursement.  Commonly termed "pay for performance"(P4P), these arrangements are increasingly employed in the Medicare (i.e., under the Medicare Access and CHIP Reauthorization Act, or MACRA) and Medicaid programs and by commercial insurers, most notable accountable care models and bundled payment arrangements.   One might assume because P4P models are now common there is research evidence that demonstrates they are effective in, again, improving care quality, patient outcomes and lowering spending growth.  That is not the case.  For example, a systematic review published by Cochrane in 2011 found "there is insufficient evidence to support or not support the use of financial incentives to improve the quality of primary health care."  Among other examples, for all the attention the Massachusetts' Alternative Quality Contracts (AQCs) have received since they were launched in 2009, it remains unclear if they have reduced spending or spending growth.   Because P4P models have not proved out, payers and providers, for example, England's National Health Service and in the US the integrated, 12 hospital system, Geisinger Health, have substantially reduced incentive payments or are returning to paying providers straight salaries.            During this 27 minute conversation, Professor Soumerai discusses his interest in the P4P topic, describes P4p arrangements, summarizes his and others' review of the research evidence relative to the effectiveness of P4P arrangements and suggests model designs that may be more effective.  Stephen B. Soumerai is Professor of Population Medicine at Harvard Medical School and Harvard Pilgrim Health Care Institute.  He also co-chairs the Statistics and Evaluative Sciences concentration within Harvard University's health policy Ph.D. program.  Dr. Soumerai recently served as International Trustee for the Canadian Health Services Research Foundation.  Dr. Soumerai has published more than 250 original scientific articles in leading scientific journal, such as the New England Journal of Medicine and the Journal of the American Medical Association.  He is well known nationally and internationally for his work on the impacts of health policies and methods to improve the quality of medical practice.  He frequently advises Congress, state legislatures and federal and international agencies on the design of drug cost containment, coverage and quality-of-care policies, evidence-based health policy and his research has been used extensively to support expanded economic access to medications in Medicaid and Medicare. He is the recipient of numerous honors including numerous article of the year awards from national and international scientific societies, named lectureships, and is the recipient of the Everett Mendelsohn Excellence in Mentoring Award from the Harvard University Graduate School of Arts and Sciences.Professor Soumerai's 2015 and 2016 CDC articles noting in this discussion are at: https://www.cdc.gov/pcd/issues/2015/15_0187.htm and https://www.cdc.gov/pcd/issues/2016/16_0133.htmA summary of these works can be found at: http://www.vox.com/the-big-idea/2017/1/25/14375776/pay-for-performance-doctors-bonuses This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

This is the second segment in a three-part series about the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This segment explains the criteria for receiving incentive payments through Advanced Alternative Payment Models (APMs). It also identifies the shared savings models that will qualify as Advanced APMs. Speaker: Ryan Severson Download Program Materials

This is the first segment in a three-part series about the Medicare Access and CHIP Reauthorization Act of 2015. It provides an overview of the reporting and payment periods under the Merit-Based Incentive Payment System (MIPS), as well as introduces Advanced Alternative Payment Models (APMs). The segment also discusses the future of MACRA under the leadership of President Trump and Secretary of the U.S. Department of Health & Human Services, Thomas Price. Speaker: Limo Cherian Download Program Materials

As Andy Slavitt, MBA, acting administrator of CMS, comes to the end of his tenure, he spoke with Mandi Bishop, MA, CEO of Aloha Health, about the task of making health policy translatable and the legacy of payment reform he leaves behind. During his tenure, Slavitt, who has held the position since March 2015, oversaw the rollout of a number of new payment models to move healthcare to a value-based care system, including the implementation of the Medicare Access and CHIP Reauthorization Act. In addition, he has made a point to work on providing Americans with tools to help them find the best hospitals. In the interview with Bishop, he offered insights for the incoming administration in the continued move toward value-based care.

At the fall live meeting of The American Journal of Managed Care's ACO & Emerging Healthcare Delivery Coalition, speakers discussed how to care for complex patients, and the latest in reimbursement. The week before the Coalition met, CMS released the final rule for the Medicare Access and CHIP Reauthorization Act, which was a huge topic of conversation. Among the speakers was CMS' Kate Goodrich, MD, who joined a panel discuss the particulars of the rule and how providers will be impacted. Here we present key takeaways from the sessions and panels presented at the Coalition meeting in Philadelphia in the words of the presenters themselves.

1) Progression of brain atrophy in PSP and CBS over six months and one year2) What's Trending: Interview with Mike Amery about Medicare Sustainable Growth Rate repeal and the Medicare Access and CHIP Reauthorization Act 3) Topic of the month: How to examine and approach movement disordersThis podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. John Morgan interviews Dr. Adam Boxer about his paper about on progression of brain atrophy in progressive supranuclear palsy and corticobasal syndrome. Dr. Ted Burns is interviewing Mike Amery for our “What's Trending” feature of the week about Medicare Sustainable Growth Rate repeal and the Medicare Access and CHIP Reauthorization Act. In the next part of the podcast Dr. Alberto Espay interviews Dr. Rodger Elble on the topic of “how to approach” tremor disorders.DISCLOSURES: Dr. Morgan is a consultant for Impax, Lundbeck Inc., National Parkinson Foundation, Teva Pharmaceutical Industries Ltd., and Veloxis; serves on the speakers' bureau of Impax and Teva Pharmaceutical Industries Ltd.; received compensation for review of medical records and expert witness testimony in multiple cases of litigation involving neurologic co; receives research support from National Parkinson Foundation, Parkinson's Outcome Project Grant and the NIH.Dr. Boxer serves on the scientific advisory board for Alector, Asceneuron and Delos; received funding for travel from the International Society for CNS Clinical Trials Methodology, the Movement Disorders Society, the Association for Frontotemporal Degeneration, Fidelity Biosciences Research Institute and the Tau Consortium; is a consultant for Abbvie, Ionis, Janssen and Merck Serono; holds stock options in Alector and Delos; receives research support from Avid, Biogen Idec, BMS, C2N, Cortice, Forum, Genentech, Inc., Janssen, Pfizer Inc, Eli Lilly and Company, Roche, TauRx, The Tau Research Consortium, the Bluefield Project, Corticobasal Degeneration Solutions, the Alzheimer's Association and the NIH.Dr. Ted Burns serves as Podcast Editor for Neurology®; and has received research support for consulting activities with UCB, CSL Behring, Walgreens and Alexion Pharmaceuticals, Inc.Dr. Amery is employed as Legislative Counsel for the American Academy of Neurology.Dr. Espay serves as Associate Editor for the Journal of Clinical Movement Disorders; serves as an editorial board member of Parkinsonism and Related Disorders and The European Neurological Journal; serves on the scientific advisory board for Solvay Pharmaceuticals, Inc. (now Abbvie), Chelsea Therapeutics International, Ltd., Teva Pharmaceutical Industries Ltd., Impax, Merz Pharmaceuticals, Inc., Pfizer Inc, Solstice Neurosciences, Eli Lilly and Company, ACADIA Pharmaceuticals, Inc. and USWorldMeds; is a consultant for Chelsea Therapeutics International, Ltd., Solvay Pharmaceuticals, Inc. (now Abbvie), ACADIA Pharmaceuticals, Inc., Cynapsus and Lundbeck, Inc; receives royalties for publications of books from Lippincott, Williams & Wilkins and Cambridge University Press; serves on the speakers' bureau of UCB, Teva Pharmaceutical Industries Ltd., American Academy of Neurology and Movement Disorders Society; receives research support from the CleveMed/Great Lake Neurotechnilogies, Michael J. Fox Foundation and the NIH.Dr. Elble receives research support from GlaxoSmithKline, Teva Pharmaceutical Industries Ltd., Phytopharm, Pfizer Inc, Ortho-McNeil, Spastic Paralysis Research Foundation of Kiwanis International, Illinois-Eastern Iowa District and the NIH.

Rachel Meyer, ASN Director of Policy and Government Affairs, speaks about the proposed Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) law and the influence this will have on nephrology and kidney patient care.

Rachel Meyer, ASN Director of Policy and Government Affairs, speaks about the proposed Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) law and the influence this will have on nephrology and kidney patient care.

Rachel Meyer, ASN Director of Policy and Government Affairs, speaks about the proposed Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) law and the influence this will have on nephrology and kidney patient care.

Rachel Meyer, ASN Director of Policy and Government Affairs, speaks about the proposed Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) law and the influence this will have on nephrology and kidney patient care.

Listen NowThe 2015 Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) will sunset three current Medicare performance measurement and incentive payment programs in 2018.  (This year, 2016, will be the last year these programs will be measuring and rewarding Medicare physician performance.)  These are: the Physician Quality Reporting System (PQRS); the HIT Meaningful Use (MU) program; and, the Value-Based Modifier (VM) Program.  The VM Program, modified under the 2010 Affordable Care Act, is designed to incent Medicare physician performance by updating annual Part B physician payments based on their quality and cost (or spending) performance.  (The performance and payment years are two years apart, e.g., the 2016 payment year is based on 2014 performance.)     During this 23 minute conversation Ms. Cleary explains how the VM program is designed, how physicians have performed to date under the program, the extent to which physicians use VM data to inform or improve their practice, how the program will be translated, or continue, under the MACRA Merit-Based Incentive Payment System (MIPS) and quality and value performance expectations under MIPS beginning in 2017, the first MACRA performance year.   Ms. Kelly Cleary is a DC-based health care attorney with the firm Akin Gump.  Her work primarily concerns health care related legislative and regulatory initiatives, matters involving state and federal fraud and abuse laws and cybersecurity, privacy and data protection issues.  Prior to joining Akin Gump, Ms. Clearly clerked for the Honorable Claude M. Hilton in the US District Court for the Eastern District of Virginia.  She was graduated from Catholic University's School of Law.  While there she served as editor-in-chief of the Catholic University Law Review.   For more on the CMS VM program go to: https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeedbackprogram/valuebasedpaymentmodifier.html This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowMeasuring health care quality and outcomes effectively and efficiently remains a daunting task.  Quality measures are largely seen as too process versus outcome focused, substantially irrelevant to patients and insufficiently aligned between and among payers.  Measuring care or care quality, ironically, can and does detract from actual care delivery, can have no relationship to spending efficiency and on its own is costly.  A recent article published in Health Affairs found physician practices spent over $15 billion in 2014 in reporting quality measures.  Concerning the Medicare program's quality measurement activities, MedPAC in a 2014 report to the Congress went so far as to state, "Medicare's current quality measurement approach as gone off the rails." During this 23 minute conversation Dr. Burstin briefly describes the work of the National Quality Forum (NQF), the work done by the CMS-led Core Measure Collaborative, quality measurement under the CMS proposed MACRA (Medicare Access and CHIP Reauthorization Act) rule, risk adjusting measures for socio-demographic factors, the role of PREMS and PROMS or patient reported experience and outcome measures and correlating care quality and spending or measuring for healthcare value.  Dr. Helen Burstin is the Chief Scientific Officer at the NQF.  Prior to serving in her current position, Dr. Burstin was NQF's Senior Vice President for Performance Measurement.  Prior to NQF Dr. Burstin was the Director of the Center for Primary Care at the DHHS Agency for Healthcare Research and Quality (AHRQ).  Prior to AHRQ, Dr. Burstin was an Assistant Professor at Harvard Medical School and the Director of Quality Measurement at the Brigham and Woman's Hospital in Boston.  Dr. Burstin has published more than 80 articles and book chapters on quality, safety and disparities.  She was recently selected as a 2015-2016 Baldridge Executive Fellow.  She currently is also is a Professorial Lecturer in the Department of Health and Policy and a Clinical Associate Professor of Medicine at George Washington University and serves as a preceptor in internal medicine.For information concerning NQF go to: http://www.qualityforum.org/Home.aspx This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Medicare, cybersecurity, favors for banks, mortgages, IRS bullying, a tax cut for the rich, and a couple of good ideas are highlighted from the law and bills that passed Congress in April. Please support Congressional Dish: Click here to contribute with PayPal or Bitcoin; click the PayPal "Make it Monthly" checkbox to create a monthly subscription Click here to support Congressional Dish for each episode via Patreon Mail Contributions to: 5753 Hwy 85 North #4576 Crestview, FL 32536 Thank you for supporting truly independent media! Laws H.R. 2: Medicare Access and CHIP Reauthorization Act of 2015 Sustainable Growth Rate (SGR): Enacted in 1997, the SGR paid doctors for Medicare patients based on the growth in gross domestic product (GDP). If Medicare costs increased more than GDP, doctors payments were cut across the board. According to the American College of Physicians, this formula for payment has meant that the Medicare payment rate to doctors is essentially the same as it was in 2001 and cuts have been postponed so many times that doctors' payments would have been cut by 21% if this bill was not signed into law by April 1. This new law: Repeals the Sustainable Growth Rate formula for Medicare payments to doctors. Increases payments to doctors by 0.5% through 2019 while the payment rate transitions away from a pay-per-service model. The new system will be based on scores assessed by a "Merit-based Incentive Payment System" which will be created by the Secretary of Health and Human Services which will go into effect on January 1, 2019. A list of "quality measures" will be posted every November and doctors can choose which one's will be used in their performance assessments. Doctors will be rated and paid based on a performance score from 0 to 100, which will take improvement into account starting in the second year of the program. The GAO will report on the effectiveness of the system by October 1, 2021. An advisory committee will be created to propose alternative payment models, which will be lump sum payments to group practices and medical homes. Sets a goal for Medicare records to be electronic nation-wide by December 31, 2018. Extends a bunch of existing Medicare programs, including the Children's Health Insurance Program (which covers low income kids whose parents make too much for Medicaid) for two years. Doubles the length of Medicare administrator contracts from five to ten years. Expands nationally a prior authorization requirement for "repetitive scheduled non-emergent ambulance transport" Prohibits the printing of social security numbers on Medicare cards Pays for the new system by... Denying access to policies with no out of pocket costs to people who enter Medicare after January 1, 2020. For all future beneficiaries, they will have to pay at least $147 per year (the cost of the Medicare Part B deductible). Increasing the premiums for relatively high income individuals. People who have a gross income between $133,501 and $160,000 ($267,000 and $320,000 for a couple) will pay a 65% premium instead of 50%, and people above that will pay an 80% premium rate. This would increase with inflation beginning in 2020. Has a huge increase in the levy that the Treasury Department can impose on tax delinquent service providers, increasing it from 30% to 100%, effective on October 16, 2015. Will have auditors distribute information about improper payments to help reduce the number of them. Creates a paper-free option for Medicare notices, saving mail fees. The effect this bill will have on the budget will not be counted. The Congressional Budget Office (CBO) estimates this bill will increase the budget deficit by $141 billion. Passed 392-37 in the House and 92-8 in the Senate Sponsored by Rep. Michael Burgess of Texas 95 pages Bills H.R. 1731: National Cybersecurity Protection Advancement Act of 2015 For reference, here's the text as of March 2015 of the Homeland Security Act, which is amended by this bill. This bill: Adds "private entities" to the list of groups that will be part of the National Cybersecurity and Communications Integration Center, which coordinates information sharing between the Federal government and other entities. Adds new groups to the list of who will be included in the National Cybersecurity and Communications Integration Center who will coordinate with all sizes of businesses. Expands the type of information that the National Cybersecurity and Communications Integration Center will share between the Federal government, local governments, and private sector. Authorizes the National Cybersecurity and Communications Integration Center to share information internationally. Requires the government and businesses to use existing technology to "rapidly advance" implementation of "automated mechanisms" for sharing between the National Cybersecurity and Communications Integration Center and Federal agencies. Participation by non-Federal entities will be voluntary. Agreements that exist before this bill is signed into law will be deemed compliant with this law. All participating entities need to take "reasonable efforts to remove information that can be used to identity specific persons". There's no listed punishments if they don't. The Under Secretary for Cybersecurity and Infrastructure Protection will create policies for governing the use of information shared with the National Cybersecurity and Communications Integration Center 180 days AFTER the bill becomes law. He/she will also be responsible for creating "sanctions" for government employees who disregard his/her privacy policies. Private entities that share information will have immunity from lawsuits, if they share information according to this law. If the Federal government breaks this law, it will have to pay the person actual damages or $1,000, whichever is higher, plus attorneys fees. There is a two year statute of limitations. This law will trump state laws that limit information sharing. The law would sunset 7 years after enactment. Passed 355-63 in the House Sponsored by Rep. Michael McCaul of Texas 60 pages H.R. 1560: Protecting Cyber Networks Act Contains the text of H.R. 1731: National Cybersecurity Protection Advancement Act Within 90 days of enactment, the Director of National Intelligence must develop procedures for sharing classified "cyber threat indicators" with "non-Federal entities" Allows cybersecurity monitoring of government systems to be privatized Allows "non-Federal entities" to share information to with anyone other than the Defense Department. The entity sharing information must "take reasonable efforts" to remove personally identifiable information on people "not directly related" to the cybersecurity threat. The President will develop polices governing what happens to information received by the Federal Government, within 90 days of the bill becoming law. The Attorney General will create policies relating to privacy and civil liberties, within 90 days of the bill becoming law. A new branch, with 50 or less employees, will be created within the Office of the Director of National Intelligence called the Cyber Threat Intelligence Integration Center, which will "serve as the primary organization within the Federal Government for analyzing and integrating all intelligence possessed or acquired by the United States pertaining to cyber threats." Information shared with the government is exempt from public disclosure. Information given to the government "shall not be subject to a rule of any Federal department or agency or any judicial doctrine regarding ex parte communications with a decision-making official." The government can keep and use information given to it to investigate, prosecute, prevent or mitigate a threat of "death or serious bodily harm or an offense arising out of such a threat" and to investigate, prosecute, prevent or mitigate a threat to a minor. The information can also be used to prevent, investigation, disrupt, or prosecute fraud, unauthorized access to computers and transmission of information taken from it, "serious violent felonies" including murder, manslaughter, assault, sexual abuse, kidnapping, robbery, carjacking, extortion, firearms use, firearms possession, or attempt to commit any of these crimes, espionage including photographing or sketching defense installations, and theft of trade secrets. Passed 307-116 in the House Sponsored by Rep. Devin Nunes of California 121 pages H.R. 650: Preserving Access to Manufactured Housing Act of 2015 Changes the definition of "Mortgage originator" to exclude mobile home retailers who take mortgage loan applications, negotiate loans, or advise consumers on loan terms (including rates, fees, and other costs) This exempts mobile home dealers from licensing, registry, a law prohibiting payment based on the terms of the loan, regulations prohibiting steering customers towards loans they can't repay or with excessive fees, regulations prohibiting mischaracterizing a customer's credit history, regulations prohibiting the mischaracterization of the appraised value of the home, or steering a customer towards a loan that's more expensive than others that they qualify for. Increases the interest banks can charge people buying a home for under $75,000 without the loan being labeled as "high-cost", which subjects the loans to Consumer Financial Protection Bureau regulations. The regulations this would exempt the loans from: Ban balloon payments, which is an oversized payment due at the end of a mortgage Prohibit banks from charging prepayment penalties and fees Restrict late fees to four percent of the payment that is past due Bans fees for loan modification Require banks make sure the loan can be repaid before offering it Prohibit banks from recommending that a customer default on a loan Require that banks receive a confirmation that the customer has received homeownership counseling before they accept a high-cost mortgage. Would allow banks to charge $3,000 or 5% in fees for loans under $75,000, whichever is greater. Current law says banks can charge 5% for loans over $20,000, so the $3,000 fee option would hit the smaller loans the hardest. Passed the House 263-162. Rep. Walter Jones of North Carolina was the only Republican no vote. The bill would be vetoed by President Obama. Sponsored by Rep. Stephen Fincher of Tennessee He took $15,150 from Clayton Homes for the 2014 election, his #4 donor and Clayton Home's #1 recipient of funds. Jeb Hensarling, the Chairman of the House Financial Services Committee was Clayton Homes #2 recipient in 2014, giving him $8,750. 4 pages H.R. 685: Mortgage Choice Act of 2015 By changing the definition of what charges count as "points and fees", this bill... Reverses a Dodd-Frank requirement that charges for title insurance be counted as points and fees if they're paid to an affiliate of the bank/creditor that issued the loan. Currently, points and fees can not be greater than 3% of the loan amount, which include fees charged by affiliated settlement providers. Every thing that gets exempted from counting as "points and fees" therefore becomes additional charges the lender is allowed to tack on to a mortgage. Exempts money held in escrow for insurance from being considered points and fees, which exempt insurance charges from the fee caps. The change in definition allows more fees to be charged to mortgages, while keeping those mortgages from being classified as "high-cost" and being subject to greater restrictions. This is a zombie bill from the 113th Congress; it passed by voice vote on June 9, 2014. Passed the House 286-140. Rep. Walter Jones of North Carolina was the only Republican no vote. Sponsored by Rep. Bill Huizenga of Michigan His top three contributing industries are - in this order - Insurance ($273,265), Real Estate ($218,175), and Commercial Banks ($193,000). 4 pages H.R. 299: Capital Access for Small Community Financial Institutions Act of 2015 Federal Home Loan Banks are privately owned cooperatives, funded by the global credit market, which provide money to local banks. There are twelve of them around the country and they are owned by the member banks. Most local banks are members of least one Federal Home Loan Bank. Allows privately insured credit unions to become members of Federal Home Loan Banks if they are FDIC eligible or are certified by the State. If the State doesn't get to it in under 6 months, the application is deemed approved. Zombie bill from the 113th Congress Passed the House by voice vote Sponsored by Rep. Steve Stivers of Ohio His top three contributing industries over the course of his four year Congressional career have been Insurance ($898,858), Commercial Banks ($534,622), and Securities and Investment ($502,098). 6 pages H.R. 1259: Helping Expand Lending Practices in Rural Communities Act Orders the Consumer Financial Protection Bureau to create an application process for people or companies to have their location designated as "rural" This would allow residents to become eligible for certain mortgages and exempt lenders from regulations intended for urban areas, according to Phil Hall of National Mortgage Professional Magazine Sunsets after 2 years. Zombie bill from the 113th Congress Passed the House 401-1. Nydia Valazquez of New York was the only no vote. Sponsored by Rep. Andy Barr of Kentucky He has taken $333,800 from the Securities & Investment industry during his 3 years in Congress. 4 pages H.R. 1195: Bureau of Consumer Financial Protection Advisory Boards Act Creates paid advisory boards for the Consumer Financial Protection Bureau made up of bankers Places limits on funding for the Consumer Financial Protection Bureau Passed the House 235-183, with 4 Democrat Ayes and 5 Republican Nays President Obama would veto the bill Sponsored by Rep. Robert Pittenger of North Carolina His #4 and #5 contributing industries are Securities & Investment and Commercial Banks; he's taken a combined $189,450 during his 3 years in Congress 7 pages H.R. 1314: Ensuring Tax Exempt Organizations the Right to Appeal Act Became the vehicle for Trade Promotion Authority in the Senate Creates an appeal process for organizations that are denied tax-exempt status Would apply to decisions made on or after May 19, 2014. Passed the House by voice vote Sponsored by Rep. Patrick Meehan of Pennsylvania 4 pages H.R. 1026: Taxpayer Knowledge of IRS Investigations Act Gives the Treasury Secretary the option of telling organizations if they are investigating a claim of unauthorized information disclosure by a government, if the investigation substantiated their claim, and if any action, including prosecution, is planned. Passed the House by a voice vote Sponsored by Rep. Mike Kelly of Pennsylvania 3 pages H.R. 709: Prevent Targeting at the IRS Act Allows the IRS to fire employees who steer and audit for a political purpose or for personal gain. Passed the House by a voice vote Sponsored by Rep. James Renacci of Ohio 2 pages H.R. 1104: Fair Treatment for All Gifts Act Makes gifts made to 501(c)4 "social welfare" groups, 501(c)5 labor and agricultural groups, and 501(c)6 business groups (including chambers of commerce, real-estate boards, and professional football leagues) tax exempt. Passed the House by voice vote Sponsored by Rep. Peter Roskam of Illinois 3 pages H.R. 1058: Taxpayer Bill of Rights Act Tells the IRS Commissioner to "ensure" that IRS employees are "familiar with and act in accord" with a list of "taxpayer rights" including The right to be informed The right to quality service The right to pay no more than the correct amount of tax The right to challenge the position of the Internal Revenue Service and be heard The right to appeal a decision of the Internal Revenue Service in an independent forum The right to finality The right to privacy The right to confidentiality The right to retain representation The right to a fair and just tax system Passed the House by a voice vote Sponsored by Rep. Peter Roskam of Illinois 3 pages H.R. 1152: IRS Email Transparency Act Prohibits IRS employees from using personal email accounts for official business Passed the House by a voice vote Sponsored by Rep. Kenny Marchant of Texas 2 pages H.R. 1105: Death Tax Repeal Act Repeals the estate tax for anyone who dies after the bill is signed Repeals the generation-skipping transfer tax, which is a tax on gifts and transfers of wealth to unrelated people who are more than 37.5 years younger than the donor, or to related people who are one generation younger. Would lower the top gift tax rate from 40 to 35 percent. The effects of this on the budget would not be counted. The CBO says this would increase the deficit by $269 billion over the next 10 years President Obama would veto the bill. Passed by 240-179 Sponsored by Rep. Kevin Brady of Texas 7 pages H.R. 622: State and Local Sales Tax Deduction Fairness Act Permanently extends the law that allows taxpayers who itemize their claims to deduct their state's sales taxes instead of getting a deduction for their state's income taxes. The effect of this bill on the budget would not be counted. CBO says this would increase the Federal deficit by $42 billion over the next ten years. President Obama would veto the bill. Passed the House 272-152. Rep. Walter Jones of North Carolina was the only Republican no vote Sponsored by Rep. Kevin Brady of Texas 2 pages H.R. 1562: Contracting and Tax Accountability Act of 2015 Stops Federal agencies from contracting with companies that are tax delinquent A waiver can be issued and the contract granted if a report is submitted to Congress saying that the contract "significantly affects the interests of the United States" Passed the House 424-0 Sponsored by Rep. Jason Chaffetz of Utah 9 pages H.R. 471: Ensuring Patient Access and Effective Drug Enforcement Act Makes the Attorney General list specific laws and regulations that a drug company is accused of violating in their notices to the companies regarding the possible suspension of their drug's registration. Allows drug companies to submit a "corrective action plan" when their drug registration may be suspended Passed the House by a voice vote Sponsored by Rep. Tom Marino of Pennsylvania His top contributing industry for the last election was the pharmaceutical industry; they gave him $55,250. 6 pages S. 971: Medicare Independence at Home Medical Practice Demonstration Improvement Act Increases the length of Medicare contracts for at-home care from 3 years to 5 years Passed the Senate by a voice vote Sponsored by Senator Ron Wyden of Oregon 2 pages H.R. 373: Good Samaritan Search and Recovery Act Clarifies that search and rescue volunteers are not Federal volunteers and are not entitled to Federal compensation. Releases the government from liability for allowing search and rescue teams onto Federal land so that they won't have to get insurance. The government as to approve or deny a request for a search and rescue mission within 48 hours. Passed the House 413-0 Sponsored by Rep. Joe Heck of Nevada Rep. Heck introduced the bill in response to the murder of Keith Goldberg; the search for his body in the Lake Mead National Recreation Area was delayed because the search team needed a special use permit and a $1 million insurance policy. It took 10 months to get the insurance; his body was found 3 hours after their search began. The National Association for Search and Rescue and the National Park Service, however, don't think access is a problem. 6 pages S. 304: Motor Vehicle Safety Whistleblower Act Protects the identity of whistleblowers who provide information relating to motor vehicle defects or other dangerous safety problems. Allows the government to give up to 30% of the fine collected from a car company that breaks the law to the whistleblower whose information lead to the conviction. The whistleblower is not allowed to be represented by a lawyer. Passed the Senate by a voice vote Sponsored by Senator John Thune of South Dakota Senator Thune has taken over $380,000 from the automotive industry 11 pages S. 984: Steve Gleason Act of 2015 Starting in 2016, Medicare would cover speech generating devices. Allows people to own their speech generating devices (as opposed to renting them) if purchased between October 1, 2015 and October 1, 2018. Named after former NFL football player Steve Gleason, who played for the New Orleans Saints before being diagnosed with ALS Passed the Senate of a voice vote Sponsored by Senator David Vitter of Louisiana 3 pages Hearings Rules Committee: April 13 on HR 650 and HR 685, about housing bills. Rules Committee: April 21 on HR 1731 and HR 1560 on Cybersecurity House Committee on Financial Services: March 18 hearing on deregulation for banks titled "Preserving Consumer Choice and Financial Independence" Information Presented in This Episode Article: 'Doc fix' headed to president's desk after easily clearing Senate by Paul Demko, Modern Healthcare, April 14, 2015. Article: The mobile-home trap: How a Warren Buffett empire preys on the poor by Mike Baker and Daniel Wagner, The Seattle Times, April 2, 2015. Article: MBA's Mortgage Action Alliance: A Message from MAA Chairman Fowler Williams by Fowler Williams, National Mortgage Professional Magazine, June 11, 2015. Article: U.S. Bank Profits Near Record Levels by Robin Sidel and Saabira Chaudhuri, Wall Street Journal, August 11, 2014 Article: Bureaucracy hindered search for slain brother by Anjeanette Damon, USA Today, March 8, 2014. Webpage: About the National Cybersecurity and Communications Integration Center, Department of Homeland Security. Webpage: Team Gleason Press Release: Rep. Kelly Introduces Taxpayer Knowledge of IRS Investigations Act Additional Information Kickstarter: Explore Campaign Finance App by Soloman Kahn. Jen's Podcast Appearances Episode 66: Talk Nerdy with Cara Santa Maria Episode 42: Podcast Junkies with Harry Duran Music Presented in This Episode Intro & Exit: Tired of Being Lied To by David Ippolito (found on Music Alley by mevio) Ask Your Doctor by Neal Fox (found on Music Alley by mevio) Thank you by Ben Willmott (found on Music Alley by mevio)

Blair Childs, SVP of Public Affairs at Premier, Inc discusses the implications to providers of the recently enacted Medicare Access and CHIP Reauthorization Act of 2015.

When the Medicare Access and CHIP Reauthorization Act of 2015, commonly known as the “doc-fix” legislation, becomes law, some Medicare participants will pay 30% more for their Part B premiums. The legislation, which was decisively passed by the House on March 26 and the Senate on April 14 is expected to be signed by President […] The post Medicare Part B premiums increasing up to 30% appeared first on Retirement Income Center.

When the Medicare Access and CHIP Reauthorization Act of 2015, commonly known as the “doc-fix” legislation, becomes law, some Medicare participants will pay 30% more for their Part B premiums. The legislation, which was decisively passed by the House on March 26 and the Senate on April 14 is expected to be signed by President […]