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The Physician Quality Reporting ... It is an example of a "pay for performance" program which rewards providers financially for reporting healthcare quality data to ...
HCFA was renamed the Centers for Medicare and Medicaid Services on July 1, 2001. [9] [11] In 2013, a report by the inspector general found that CMS had paid $23 million in benefits to deceased beneficiaries in 2011. [12] In April 2014, CMS released raw claims data from 2012 that gave a look into what types of doctors billed Medicare the most. [13]
The Sunshine Act requires manufacturers of drugs, medical devices, biological and medical supplies covered by the three federal health care programs Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP) to collect and track all financial relationships with physicians and teaching hospitals and to report these data to the Centers for Medicare and Medicaid Services (CMS).
HEDIS results must be audited by an NCQA-approved auditing firm for public reporting. NCQA has an on-line reporting tool called Quality Compass that is available for a fee of several thousand dollars. It provides detailed data on all measures and is intended for employers, consultants and insurance brokers who purchase health insurance for groups.
The Medicare Shared Savings Program is a voluntary program that encourages hospitals and healthcare providers to work together to provide high quality, cost effective care to Medicare enrollees.
After the initial March 2011 regulations, CMS received feedback regarding streamlining the governance and reporting burdens and improving the potential financial return for ACOs willing to make the necessary, and often substantial, investments to improve care. [22] On October 20, 2011, DHHS released the final MSSP regulations.
Qalsody received the U.S. Food and Drug Administration's accelerated approval last year, but CMS said it found many Medicare Advantage plans, which cover adults 65 years and older or those with ...
NPI data is downloadable from CMS. The downloadable database was updated monthly until December 2012, and has been issued weekly since. A data structure file is available separately from CMS. [6] As of June 2024, the file download size is 947.84 MB, and the raw database file (npidata_pfile_20050523-20240512.csv) is 9.3 GB when extracted. [7]