SGR Repeal Bill Advances to Full House Committee
Beginning in 2019, physicians receiving fee-for-service reimbursement will receive an additional update adjustment based on quality performance under the update incentive program (UIP). Performance will be assessed based on quality measures and clinical practice improvement.
Providers and other stakeholders will have a say in the development and selection of the UIP quality measures. High-performing providers will have the opportunity to earn a 1% bonus payment, while low performing providers will see a 1% reduction in payments.
Alternative payment models
Beginning in 2015, providers and other stakeholders may submit proposals for new payment models to an independent entity that will review proposals and make recommendations to the Department of Health and Human Services for models to move forward as either a demonstrations or permanent programs.
Care coordination and patient-centered medical homes
The bill establishes new payment codes for complex chronic care management. The legislation also ensures that Medicare payment is available for care coordination services performed by physicians who are certified as a level III medical home by the National Committee on Quality Assurance, recognized as a patient-centered specialty practice by the National Committee on Quality Assurance, and have received equivalent certification or meet other comparable qualifications.
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