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Live Webinar

90-minute live streaming program
  • December 3
  • 1:00 - 2:30 pm EST

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OnDemand Webinar

Medicare's Overhaul of Physician Payments

December 3

Gain an understanding of the updated payment changes reflective in the new year within Medicare restructured specifically for physicians.

Medicare is expected to impose far-reaching changes in how physicians are paid starting in 2019. The Centers for Medicare & Medicaid Services (CMS) has proposed the first major re-do in almost 20 years in how evaluation and management (E&M) services will be paid – these are an important part of billings for almost all specialties. CMS has proposed to simplify the E&M payment structure in ways that will, if adopted as proposed, create winners and loser and be disruptive for many specialties. This rule also contains various changes in the Quality Payment Program (QPP) that will affect physicians that do not participate in Advanced Alternative Payment Mechanisms, which include certain Accountable Care Organizations. CMS has also proposed various changes to Medicare’s ACO program; the proposals have been criticized as ‘raising the bar’ for ACOs, making this alternative more difficult for physicians to use to share in savings or avoid payment cuts. Physician practices will thus have to weigh a revised set of options as they seek to avoid payment reductions and secure higher payments for their services. This topic will explore the changes CMS actually adopts for implementation in 2019 and equip participants to understand and react appropriately to these changes.

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Agenda

Changes in Payment for Evaluation and Management Services
  • Changes in Documentation Requirements
  • Proposals to Simplify the E&M Levels of Payment
  • Add-on Provisions for Particular Physician Services
Other Changes Affecting Physician Payment
  • Global Surgery Periods
  • Payment Rates for Practice Expense Inputs
Changes in the Quality Payment Program
  • Addition, Removal, and Revisions to Measures
  • Increased Weight Placed on Cost Performance Category
  • New Scoring Methodologies for Promoting Interoperability Category
  • What Do the Changes Do to Help Physicians Meet QPP Reporting Requirements and Avoid Payment Cuts?
Changes in Accountable Care Organizations
  • Which ACOs Are Affected and How
  • Toughening up of Requirements to Bear Risk
  • Improvements in Coverage of Services
  • Simplified Reporting Requirements
  • Are ACOs Still a Useful Strategy for Avoiding QPP Reporting Requirements and Possible Payment Reductions?
Summing up
  • Effects of the New Regulations on Physician Practices
  • What Can Physicians Do to Respond?
  • How Will These Changes Affect Companies That Supply Pharmaceuticals, Devices, and Other Inputs to Medical Care
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Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Credits

OnDemand Webinar

This course was last revised on February 29, 2012.

Call 1-866-352-9540 for further credit information.

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

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  • ACHE 1.5
     
  • The American College of Healthcare Executives no longer pre-approves courses or organizations. Participants in this program wishing to have the continuing education hours applied toward ACHE Qualified Education credit should indicate their attendance when submitting an application to the American College of Healthcare Executives for advancement or recertification. ACHE Qualified Education credit must be related to healthcare management (i.e., it cannot be clinical, inspirational, or specific to the sponsoring organization). It can be earned through educational programs conducted or sponsored by any organization qualified to provide educational programming in healthcare management. Programs may be sponsored by ACHE, chapters or other qualified sources, whether the programming is face-to-face or distance offerings (webinars, online seminars, self-study courses, etc.).
     
  • AHIMA 1.5 including Clinical Data Management 1.5
     
  • This program has been approved for 1.5 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.
     
  • AL CLE 1.5
     
  • This course or a portion thereof has been approved by the Alabama State Mandatory Continuing Legal Education Commission for a maximum of 1.5 hours credit.
     
  • AR CLE 1.5
     
  • This course has been approved for 1.5 hours of CLE by the Arkansas CLE Board.
     
  • Arizona CLE 1.5
     
  • The State Bar of Arizona does not approve or accredit CLE activities for the Mandatory Continuing Legal Education requirement. This activity may qualify for up to 1.5 hours toward your annual CLE requirement for the State Bar of Arizona.
     
  • CA MCLE 1.5
     
  • Lorman Business Center, Inc. is a State Bar of California approved MCLE sponsor and this course qualifies for 1.5 CLE hours of participatory credit.
     
  • CO CLE 2.0
     
  • This program may qualify for 2.0 credit hours through the Colorado Supreme Court Board of Continuing Legal and Judicial Education through reciprocity. This course is accredited in other jurisdictions such as New Jersey. To receive CLE credit for this program, a home study affidavit must be submitted to the Supreme Court Board of Continuing Legal and Judicial Education.
     
  • CT CLE 1.5
     
  • Neither the Connecticut Judicial Branch nor the Commission on Minimum Continuing Legal Education approve or accredit CLE providers or activities. This course has been approved for CLE credit in jurisdictions aside from CT and therefore it automatically meets the content and delivery requirements in Connecticut. Credit is based on a 60 minute credit hour and shall be awarded as follows: 1.5 CLE credit(s).
     
  • GA CLE 1.5
     
  • This program has been approved by the Georgia Commission on Continuing Lawyer Competency for 1.5 CLE hours.
     
  • HI CLE 1.5
     
  • This program was approved by the Hawaii State Board of Continuing Legal Education for 1.5 CLE credit hours.
     
  • IL CLE 1.5
     
  • This course was approved for a total of 1.5 hours of MCLE Credit by the Illinois MCLE Board.
     
  • ME CLE 1.5
     
  • This course has been approved by the State of Maine Board of Overseers of the Bar. Lawyers who complete this course shall receive 1.5 hours of CLE credit under M. Bar R. 12.
     
  • MS CLE 1.5 (Pending)
     
  • This program has been submitted to the Mississippi Commission on Continuing Legal Education. Approval pending.
     
  • MT CLE 1.5
     
  • This program has been approved by the Montana Commission of Continuing Legal Education for a total of 1.5 CLE credits.
     
  • NH MCLE 1.5
     
  • NH MCLE does not approve or accredit CLE activities for the NH Minimum CLE requirement. Lorman Education Services believes this course meets the requirement of NH Supreme Court Rule 53 and may qualify for CLE credit(s). Program Length: 90 Minutes.
     
  • NJ CLE 1.8
     
  • This program has been approved by the Board on Continuing Legal Education of the Supreme Court of New Jersey for 1.8 hours of total CLE credit.
     
  • NV CLE 1.5
     
  • This program has been approved by the Nevada Board of Continuing Legal Education for 1.5 CLE hours.
     
  • PA CLE 1.5
     
  • This Distance Learning program has been approved by the Pennsylvania Continuing Legal Education Board for 1.5 hours of substantive law, practice and procedure CLE credit.
     
  • RI CLE 1.5
     
  • This program has been approved by the Rhode Island Mandatory Continuing Legal Education Commission for 1.5 hours of CLE credit.
     
  • TN CLE 1.5
     
  • This program has been approved as a distance learning format by the Tennessee Commission on Continuing Legal Education for a maximum of 1.5 hours of credit.
     
  • VT CLE 1.5
     
  • This program has been approved by the Mandatory Continuing Legal Education Board of Vermont for 1.5 hours of CLE credit.
     
  • WA CLE 1.5
     
  • This program has been approved by the Washington State Board of Continuing Legal Education for 1.5 hours of Law & Legal Procedure credit.
     
  • WI CLE 1.5
     
  • This program has been approved by the Board of Bar Examiners for 1.5 hours for use toward the Wisconsin Mandatory CLE requirement.
     
  • WV MCLE 1.8
     
  • This program has been approved by the West Virginia State Bar MCLE Commission for 1.8 MCLE hours.
     
  • HFMA 1.5
     
  • This course is approved by HFMA for certification maintenance of continuous educational points and will equal 1.5 points of classroom instruction.
     

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

Who should attend?

This live webinar is designed for administrators, chief medical officers, CFOs, quality officers, compliance officers, risk managers, managed care payers, billing managers and attorneys.

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Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Faculty

Thomas Gustafson, PhD

Thomas Gustafson, PhD

Arnold & Porter LLP

  • Policy Advisor in Arnold & Porter’s Life Sciences and Healthcare Regulatory Practice, where he concentrates on Medicare reimbursement and related issues and on health policy generally
  • Distinguished 30-year career at the United States Department of Health and Human Services (HHS) in 1976 included more than 20 years at CMS, where he held several executive posts responsible for Medicare and Medicaid legislation, strategic planning, research and demonstrations, operations, and development and implementation of regulations
  • In 2003, Dr. Gustafson was named Deputy Director of the Center for Medicare Management (CMM), which coordinated the fee-for-service portion of the Medicare program and set payment rates for more than a million providers
  • Advised health-care providers, device and pharmaceutical manufacturers, and trade associations on a wide array of issue areas, including: physician, hospital and end-stage renal disease reimbursement systems; accountable care organizations; laboratory coverage, coding and payment; and launch and reimbursement issues for devices and pharmaceuticals
  • J.D. degree, Williams College; PhD, Yale University
No photo available

John McInnes, MD, JD

Arnold & Porter Kaye Scholer LLP

  • Counsel in Arnold & Porter’s Life Science and Healthcare Regulatory Practice, where he specializes in reimbursement issues affecting physicians and other practitioners and device and pharmaceutical manufacturers
  • Practiced as a board-certified ophthalmologist for several years before becoming a lawyer
  • Served for several years at CMS directing the divisions responsible for the development of national Medicare payment policies for hospital outpatient departments, ambulatory surgery centers, and physician services, among others
  • Led a team charged with developing, implementing and evaluating new payment models now included in the QPP
  • J.D. degree, University of Texas; MD degree, Duke University
Paul Rudolf, MD, JD

Paul Rudolf, MD, JD

Arnold & Porter Kaye Scholer LLP

  • Partner in Arnold & Porter’s Life Sciences and Healthcare Regulatory Practice
  • Experienced in both Medicare and FDA legal, regulatory and policy issues and is widely recognized for advising clients with coverage, coding, and reimbursement issues relating to Medicare’s physician and hospital payment systems
  • Practiced medicine for more than 15 years and taught at George Washington University before becoming a Medicare Carrier Medical director
  • Joined CMS, where he led policy development for the physician fee schedule and the hospital outpatient prospective payment system
  • J.D. degree, The George Washington University’ MD the University of Florida
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Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

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Product ID: 404541
Published 2012, 2018
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