CMS announces Next Generation ACO benefit enhancement

Beginning in January, Medicare will pay for certain care management home visits under the Next Generation Accountable Care Organization Model. Next Generation participants and preferred providers who have initiated a care treatment plan for aligned beneficiaries will be eligible to receive up to two care management home visits within 90 days of seeing that participant or provider, the Centers for Medicare & Medicaid Services told Medicare contractors Friday. “Specifically, the scope of covered items and services under this benefit enhancement include those services and supplies that would be covered under Medicare Part B, and are furnished ‘incident to’ the professional services of a physician or other practitioner,” CMS said, “with the exception that CMS will waive the direct supervision requirement such that the services and supplies may be furnished by auxiliary personnel under the billing physician’s or other billing practitioner’s general supervision.” The change applies to program year three of the Next Generation model, which qualifies as an advanced alternative payment model under Medicare’s Quality Payment Program for clinicians.