CMS Unveils Comprehensive Primary Care Plus Model

The Centers for Medicare and Medicaid Services (CMS) recently introduced a new model for primary care aimed at giving providers more flexibility in the practice of medicine. The model is based off of the Comprehensive Primary Care Initiative, launched in 2012. The updated model requires the delivery of preventive care and 24/7 patient access to care. Participants in the model are provided with an upfront incentive payment that they may be able to keep, depending on their performance. The model includes two tracks. Under the first, physicians are paid on a fee-for-service (FFS) basis, plus a monthly per-patient fee, averaging $15 per beneficiary per month, for managing each patient’s care. Under the second track, physicians are paid through a combination of reduced FFS payments and a comprehensive primary care payment (CPCP), based on the provider’s expected evaluation and management claims. These practices will also receive a care management fee averaging $28 per beneficiary per month. The model will begin in January 2017. Applications from practices looking to be a part of the Comprehensive Primary Care Plus model will be accepted between July 15 and September 1, following CMS’ announcements of the 20 regions that will participate in the model.

Upcoming Congressional Meetings and Hearings

House Energy and Commerce Committee convenes for opening statements only related to the markup of opioid legislation reported out of the Subcommittee on Health and legislation reported out of the Subcommittee on Communications and Technology; 5:00 p.m., 2123 Rayburn Bldg.; April 26

House Energy and Commerce Committee markup of 12 bills to address opioid abuse; 10:00 a.m., 2123 Rayburn Bldg.; April 27

Senate Special Aging Committee hearing on the committee’s investigation into the sudden, aggressive price spikes of decades-old prescription drugs; 3:30 p.m., 216 Hart Bldg.; April 27

Senate Finance Committee hearing on “Mental Health in America: Where Are We Now?” 2:00 p.m., 215 Dirksen Bldg.; April 28

House Veterans’ Affairs Health Subcommittee markup of pending legislation; 9:00 a.m., 334 Cannon Bldg.; April 29

Recently Introduced Health Legislation

H.R. 4976 (introduced by Rep. Sean Patrick Maloney of New York): A bill to require the Commissioner of Food and Drugs to seek recommendations from an advisory committee of the Food and Drug Administration before approval of certain new drugs that are opioids without abuse-deterrent properties, and for other purposes; to the Committee on Energy and Commerce; April 18

H.R. 4977 (introduced by Rep. Walorski): A bill to direct the Secretary of Veterans Affairs to ensure that each medical facility of the Department of Veterans Affairs complies with requirements relating to scheduling veterans for health care appointments, to improve the uniform application of directives of the Department, and for other purposes; to the Committee on Veterans’ Affairs; April 18

H.R. 4978 (introduced by Rep. Jenkins of West Virginia): A bill to require the Government Accountability Office to submit to Congress a report on neonatal abstinence syndrome (NAS) in the United States and its treatment under Medicaid; to the Committee on Energy and Commerce; April 18

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