News: CMS announces new initiative to increase clinician engagement

On October 13, CMS announced a new initiative to increase clinician engagement, including a regulatory review to begin reducing unnecessary documentation, according to a statement released by the agency.

The new program, collectively referred to as the Quality Payment Program (QPP), includes a long-term effort to continuously review regulations and policies to minimize administrative tasks and seek other input to improve clinician satisfaction. The program will roll out in multiple phases, each focusing on a different goal.

The first phase is the launch of an 18-month pilot program to reduce medical review for certain physicians. Under the program, providers practicing within specified Advanced Alternative Payment Models (APMs) will be relieved of some scrutiny under certain medical review programs.

The pilot, beginning in 2017, will consist of two phases. Phase one will include post-payment reviews, where CMS will direct Medicare Administrative Contractors (MACs), Recovery Audit Contractors (RACs), and the Supplemental Medical Review Contractor to make claims reviews from providers participating in Advanced APMs a lower priority. The second phase will focus on pre-payment reviews by MACs, who will perform analysis of fee-for-service claim data to identify atypical billing patterns.

During the pilot, CMS will monitor the progress of the program, and will determine whether to continue or expand it based on results.

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