Medical Billing Companies

Bundled Payment Programs

In the latest move, the Centers for Medicare and Medicaid Services has delayed several bundled payment initiatives. This includes the implementation of cardiac bundled payment initiatives and the expansion of Comprehensive Care for Joint Replacement Model. In addition to that, this new policy from CMS will also extend Cardiac Rehabilitation Incentive Payment Model’s effective date from July 1 to October 1.

Reports from several sources also claim that the interim rule from CMS has also delayed the effective date of a final rule for the second time. The effective date for the final rule was earlier delayed by the CMS from February 18 to March 21. However, the effective date is yet again pushed back to May 20. This rule outlines the implementation of some of the bundled payment initiatives including CJR.

However, in a recent statement, the officials from CMS also hinted that they are also planning to push back the implementation of cardiac bundled payments and CJR expansion until next year. The interim rule said, “We seek comment on the appropriateness of this delay, as well as a further applicability date delay until January 1, 2018.” The comment period on the newly proposed interim rule is open up to April 19.

Many experts in the health care industry expressed their concerns about the proposed delays. naviHealth COO Carter Paine said, “I’m not surprised at all. From a timing perspective, with Secretary Price only holding his seat for a couple weeks and Seema Verma getting confirmed last week, the prudent thing for them is to dig into these issues. I’m not surprised they’re delaying it and going through the implications.”

Medical Billing Services

Medicare And Medicaid

The newly elected secretary of the Department of Health and Human Services, Tom Price has also strongly opposed the bundled payment initiatives. He sent a letter to CMS last year, in which he asserted that the Center for Medicare and Medicaid Innovation was “experimenting with Americans’ health” through these mandatory initiatives.

However, Paine said that, “The mandatory side of the bundles is, we think, probably unlikely. We think the voluntary bundles will continue on, and we’ll see an advanced BCPI program come through in the next few months.” Paine also stated that the Republican agendas such as keeping bundled payments voluntary and proceeding with are more likely to happen with CMS Administrator Seema Verma and Secretary Price in office.