News

  • 07/01/2021 8:46 AM | Rebekah Francis (Administrator)

    Earlier this week, MGMA sent a letter to the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) asking it to rescind or delay its emergency temporary standard (ETS) aimed at protecting workers facing the highest coronavirus hazards — those working in healthcare settings where suspected or confirmed coronavirus patients are treated. MGMA believes the ETS was issued much too late and will disrupt the ongoing efforts of medical groups to balance the needs of patients against the imperative to protect employees. MGMA hopes that OSHA will rescind the ETS, or at a minimum, delay its effective date until stakeholders have adequate opportunity to provide input on the standard.

  • 07/01/2021 8:46 AM | Rebekah Francis (Administrator)

    The Centers for Medicare & Medicaid Services (CMS) announced that 2021 alternative payment model (APM) incentive payment details are now available on the QPP website. After logging in, organizations will be able to see the amount paid for eligible clinicians that achieved qualifying participant (QP) status during the 2019 performance year. Clinicians who were QPs in an advanced APM entity in 2019 should begin receiving a 5% APM incentive payment this month.

    No action is required to receive these payments unless CMS is unable to verify a clinician's Medicare billing information. If payment is not received, check the CMS public notice, which indicates the names of clinicians whose billing information could not be verified. Such clinicians will need to verify their Medicare billing information by November 1, 2021, in order to receive their APM incentive payment. For additional information, download CMS' 2021 Learning Resources for QP Status and APM Incentive Payment zip file.

  • 06/24/2021 8:43 AM | Rebekah Francis (Administrator)

    MGMA joined 12 leading healthcare organizations in supporting the Accountable Care in Rural America Act, a recently reintroduced bill that addresses the way financial targets are set for Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program. This piece of legislation would improve the accuracy and fairness in evaluating ACOs by fixing the "rural glitch," a flaw in the benchmarking methodology that disproportionately affects rural ACOs. We hope Congress acts to correct this flaw and levels the playing field for all ACOs to achieve savings when they improve quality and reduce costs.

  • 06/24/2021 8:42 AM | Rebekah Francis (Administrator)

    The Centers for Medicare & Medicaid Services (CMS) has notified MGMA that it plans to start distributing 2019 performance year advanced alternative payment model (APM) incentive payments beginning Thursday, June 24. Group practices that participated in an advanced APM in 2019 and whose clinicians achieved qualifying participant (QP) status by meeting patient or payment thresholds in 2019 should begin receiving these 5% bonus payments in the coming days. CMS plans to publish a notice for any providers that expect to receive these payments but do not, so that they can provide the agency with the appropriate information to receive their payment. 

  • 06/17/2021 1:28 PM | Rebekah Francis (Administrator)

    This morning, the U.S. Supreme Court dismissed a challenge to the Affordable Care Act (ACA), leaving the law intact. In the 7-2 decision, the justices said the challengers of the law lacked standing to bring the case. The case, California v. Texas, centered around the ACA’s individual mandate, which required individuals to obtain minimum health insurance coverage or face a tax penalty. Once the tax penalty was set to $0 in a subsequent tax law, the plaintiffs argued that without the tax consequences associated with the individual mandate, the individual mandate was unconstitutional and the rest of the ACA must be found unconstitutional as well. The Court threw out this challenge to the law today due to lack of legal standing because the plaintiffs could not show injury.

  • 06/17/2021 1:22 PM | Rebekah Francis (Administrator)

    HHS releases updated PRF reporting guidance, establishes new deadlines

    The Department of Health & Human Services (HHS) released long-awaited updates to reporting guidance for the Provider Relief Fund (PRF). According to the press release and the newly updated Post-Payment Notice of Reporting Requirements document, only relief funds received prior to June 30, 2020, must be expended by June 30, 2021, a deadline that the Department established previously. HHS designated four different reporting periods and deadlines to use funds based on the dates relief funds were initially received. HHS also heeded MGMA's recommendation to extend the 30-day reporting period to a full 90 days following the spending deadline for each period. Finally, the announcement indicates that the PRF Reporting Portal will allow providers to begin reporting their use of funds on July 1, 2021. Providers that received one or more payments exceeding $10,000 in the aggregate during a single Payment Received Period will be required to report. Additional resources, including a reporting toolkit, will become available upon the opening of the Reporting Portal. 

    OSHA announces new COVID-19 temporary standard for healthcare settings

    The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) issued a COVID-19 emergency temporary standard (ETS) and accompanying FAQ with implications for healthcare employers. In part, under the ETS, a covered employer must:

    •  Develop a “COVID-19 plan,” which includes a workplace-specific hazard assessment,
    •  Clean and disinfect the workplace,
    •  Screen employees for COVID-19 and follow requirements for removing employees from the workplace,
    •  Ensure physical distancing,
    •  Screen and monitor patients upon arrival,
    •  Report COVID-19 fatalities and hospitalizations, and
    •  Provide reasonable time and paid leave for COVID-19 vaccinations.

    See the full ETS for a complete list of requirements. Certain requirements are waived if workers are vaccinated and are in well-defined areas where there is no reasonable expectation that a person with suspected or confirmed COVID-19 will be present.


  • 06/11/2021 10:26 AM | Rebekah Francis (Administrator)

    HHS Secretary Becerra addresses PRF, guidance forthcoming

    During a House Ways and Means Committee hearing on the Department of Health and Human Services' (HHS) budget request, Secretary Xavier Becerra addressed the Provider Relief Fund (PRF) and told lawmakers that the Department would be releasing additional guidance this month. Physician practices still only have until June 30 to use any PRF money received. Last month, MGMA sent a letter to HHS recommending modifications to the PRF program, including an extension of the spending deadline and the expeditious distribution of the remaining relief funds to medical group practices and other providers.

    MSSP 2022 application period now open

    The application period for a Jan. 1, 2022, agreement start date in the Medicare Shared Savings Program (MSSP) is open now through June 28, 2021. Accountable care organizations (ACOs) seeking to apply or renew their agreement in the MSSP for 2022 must have an authorized ACO contact submit all Phase 1 application materials by June 28 at 12pm ET. For additional information, medical groups are encouraged to reference the Application Types & Timelines webpage and the MSSP Application Toolkit.



  • 06/03/2021 10:29 AM | Rebekah Francis (Administrator)

    MGMA outlines priorities in letter to new CMS Administrator

    In a welcome letter to Chiquita Brooks-LaSure, the new head of the Centers for Medicare & Medicaid Services (CMS), MGMA outlined a number of priorities it is eager to work with the agency on that will deliver high-quality, cost effective care, and help reduce regulatory burden on medical practices. The letter includes the following recommendations:

    • Include Medicare Advantage plans in the scope of CMS' interoperability and prior authorization rule;
    • Allow permanent coverage of audio-only services;
    • Support the development of new, voluntary alternative payment models (APMs); and
    • Provide transparency regarding MIPS cost category.

    MGMA provides recommendations on APM development

    MGMA joined the American Medical Association and 40 other healthcare organizations in providing recommendations on APM development to the new Director of the Center for Medicare and Medicaid Innovation (CMMI). In the letter, the provider community recommends improving the way CMMI designs and implements APMs to increase transparency, reduce health inequities, and provide up-front funding to participants to facilitate successful APM implementation. Additionally, the letter recommends engaging the physician community in the development of APMs to create alignment in priorities, dedicating funds to physician-developed APMs, and providing feedback and data to physician organizations seeking to collaborate in this process.

    President’s proposed budget gives HHS significant bump

    Last Friday, President Biden released his $6 trillion fiscal year 2022 budget request, which included notable increases to the National Institutes of Health, the Centers for Disease Control and Prevention, and the Substance Abuse and Mental Health Services Administration. President Biden also requested a 23% funding increase for the Department of Health and Human Services. Presidential budget requests do not have the force of law and are intended to display the Administration’s priorities, while Congress negotiates the budget.

  • 04/29/2021 5:55 PM | Rebekah Francis (Administrator)

    MGMA advocates for telehealth expansion

    MGMA submitted written comments to the House Ways and Means Health Subcommittee regarding its hearing on “Charting the Path Forward for Telehealth.” MGMA urges the Subcommittee and other lawmakers to consider the following when drafting Medicare telehealth legislation:

    • Preserve the patient-physician relationship;
    • Permanently remove geographic and originating site restrictions;
    • Allow permanent coverage of audio-only visits; and
    • Reimburse telehealth visits equally to in-person visits.

    During the hearing, Subcommittee members and witnesses engaged in a robust discussion covering interstate licensure legislation, the potential for using telehealth to address health disparities, and the potential for fraud. MGMA was pleased to see congressional support for audio-only services and for the removal of geographic and originating site restrictions. As Congress continues to discuss how to chart a path forward for telehealth, MGMA will advocate for policies that put medical groups in the best position to treat their patients.

    CMS releases 2022 IPPS proposed rule

    This week, the Centers for Medicare & Medicaid Services (CMS) issuedthe 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital proposed rule. The proposed rule would update Medicare payment policies and rates for acute care hospitals for FY 2022. Following MGMA advocacy and in accordance with the Consolidated Appropriations Act, 2021, CMS is proposing to distribute Medicare-funded medical residency positions to qualifying hospitals. Specifically, the 1,000 new slots will be phased in at no more than 200 slots per year beginning in FY 2023. Additionally, CMS is proposing to allow eligible Accountable Care Organizations participating in the BASIC track of the Medicare Shared Savings Program to elect to forgo automatic advancement along the glide path’s increasing levels of risk and potential reward for the 2022 performance year. CMS will accept comments on the proposed rule through June 28, 2021, and the final rule is expected later this year.

    New resources available on QPP website 

    Over the past few weeks, CMS has added new resources to the Quality Payment Program (QPP) Resource Library. For performance year 2021, the new batch of resources includes:

    • MIPS User Guides, which provides details on a variety of topics to help participants understand the 2021 MIPS performance year requirements;
    • MIPS Measures and Activities Specialty Guides;
    • Medicare Promoting Interoperability Program vs. MIPS Promoting Interoperability Performance Category Infographic;
    • Facility-based Quick Start Guide;
    • Quality Benchmarks; and
    • MIPS Data Validation criteria.

  • 04/22/2021 10:02 AM | Rebekah Francis (Administrator)

    HHS renews public health emergency for COVID-19

    Department of Health and Human Services (HHS) Secretary Xavier Becerra has renewed the public health emergency (PHE) for COVID-19 effective April 21, 2021. This extension will continue all telehealth waivers and other flexibilities pursuant to the determination. As with previous determinations, the renewed PHE will end 90 days after its effective date on Tuesday, July 20, 2021, unless it is further extended. The Biden administration has previously indicated that it plans to continue extending the COVID-19 PHE at least for the remainder of 2021. 

    MGMA supports bill to remove PRF negative tax implications

    MGMA and other leading healthcare organizations sent aletter of support to the sponsors of the Eliminating the Provider Relief Fund Tax Penalties Act (H.R. 2079). This bill would remove the negative tax implications for Provider Relief Fund (PRF) recipients by ensuring that the funds are not taxable, while maintaining that expenses tied to the funds are tax-deductible. PRF assistance is currently taxable. For more information on the PRF, see MGMA’s comprehensive resource.

    MGMA to HHS: Extend the Next Generation ACO model

    MGMA joined 12 other organizations in urging HHS Secretary Xavier Becerra to extend the Next Generation ACO (NGACO) model through 2022. Without further action, the model will expire this year. However, in light of a recent announcement from the Centers for Medicare & Medicaid Services that it does not intend to accept new applicants for the 2022 cohort of the Direct Contracting model, current NGACO participants will no longer have that as an option once this performance year ends. In addition to extending the NGACO model, the coalition urges HHS to create a permanent full risk ACO option for the future and reexamine its model evaluation reports.



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