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Pilot Program May Reduce Advanced APM Administrative Woes

Advanced Alternative Payment Models (APMs) are designed to offer benefits to participating providers such as incentive payments for participating in an innovative payment model. However, the administrative burden of participating may also deter eligible providers.

To address this issue and improve the clinician experience with the Medicare program, officials at the Centers for Medicare & Medicaid Services (CMS) are launching an 18-month pilot program aimed at reducing administrative burdens for physicians. The pilot program will relieve physicians from additional documentation scrutiny under Medicare medical review.

CMS will direct Medicare Administrative Contractors and Recovery Audit Contractors to consider doctors participating in Advanced APMs as a low-priority for post-payment claim reviews. According to the CMS Acting Administrator, Andy Slavitt, the new initiative has several aims including, β€œβ€¦to get physicians back to the most important thing they do – taking care of patients.”

The pilot program will roll out with two phases in 2017, and while CMS will consider participating doctors low priority for auditing, they will still be accountable for existing oversight from other review programs.


Byline: Martha L. Sikes, MS, RPh, PA-C

Posted: November 9, 2016

Source: Centers for Medicare and Medicaid Services
Adapted from the original press release.

[Image: Pixabay / Myrfa]

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