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Friday Nov 10, 2017

Medicare payment news for 2018: the key takeaways

As 2017 draws to a close, the Medicare program is notifying physicians how they will be evaluated and paid for treating patients in 2018. In case you’re not an avid reader of the Federal Register (and most people aren’t), let’s go over some details.


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Posted at 04:15PM Nov 10, 2017 by Kent Moore | Comments [0]

Friday Oct 13, 2017

In a small group? Combine with others now to participate in MIPS

The Centers for Medicare & Medicaid Services says physicians in solo or small group practices have until Dec. 1 to formally notify Medicare that they are participating in a virtual group. These groups make it easier for small practices to participate fully in MIPS.


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Posted at 12:30PM Oct 13, 2017 by Kent Moore | Comments [0]

Wednesday Sep 20, 2017

What’s your Medicare quality report score? Find out here.

Individual physicians and groups can now access the latest results of their annual Physician Feedback report and Quality and Resource Use Report. They provide information on the 2016 Physician Quality Reporting System and the 2016 Value-based Payment Modifier as well as if the physician or group will receive a 2018 payment adjustment under either program.


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Posted at 12:30PM Sep 20, 2017 by Erin Solis | Comments [0]

Tuesday Sep 05, 2017

Ask beneficiaries to designate you their primary clinician online

If you treat Medicare patients, you and your patients likely value the relationships you’ve formed. As Medicare continues to change how it reimburses physicians for beneficiary care, it would be helpful if the program knew about and honored those relationships, right?


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Posted at 11:45AM Sep 05, 2017 by Kent Moore | Comments [0]

Thursday Aug 10, 2017

MIPS tops list of most burdensome regulations for group practices

physician_MIPS_burden

A new survey of group medical practices shows that while many physicians expect they will be able to meet at least the minimum requirements of the Merit-based Incentive Payment System (MIPS) this year, most see it as a huge burden that affects their ability to care for patients.


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Posted at 04:14PM Aug 10, 2017 by David Twiddy | Comments [0]

Wednesday Aug 09, 2017

QPP hardship application now open

The Centers for Medicare & Medicaid Services is now accepting applications from individual physicians and medical groups that believe they are due hardship exceptions from the Quality Payment Program for the 2017 transition year.


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Posted at 11:16AM Aug 09, 2017 by Kent Moore | Comments [0]

Wednesday Jun 21, 2017

Changes to 2018 Quality Payment Program aim to help participation

The Centers for Medicare & Medicaid Services (CMS) has proposed a series of changes in the second year of the Quality Payment Program (QPP) that attempts to address some of the complaints from physicians that the original rules make participation in QPP difficult.


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Posted at 04:33PM Jun 21, 2017 by Kent Moore | Comments [0]

Thursday May 25, 2017

Deadline approaches to join new MACRA payment model

Next week is the deadline to notify Medicare if your practice intends to participate in a new payment model aimed at helping practices, particularly smaller ones, meet the Quality Payment Program requirements under MACRA.


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Posted at 12:06PM May 25, 2017 by Erin Solis | Comments [0]

Wednesday May 10, 2017

CMS provides tool to determine physicians’ MIPS participation status

The Centers for Medicare & Medicaid Services (CMS) is mailing letters alerting physicians and other health care professionals of their 2017 participation status for the Merit-based Incentive Payment System (MIPS). The agency is also offering an interactive tool on its Quality Payment Program website to determine if you should participate in 2017.


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Posted at 09:50AM May 10, 2017 by Kent Moore | Comments [0]

Thursday Apr 27, 2017

Are you participating in MIPS this year? Watch your mailbox

The Centers for Medicare & Medicaid Services (CMS) has begun mailing letters alerting physicians and other health care professionals of their 2017 participation status for the Merit-based Incentive Payment System (MIPS), one of the two reimbursement tracks under the Medicare Access and CHIP Reauthorization Act (MACRA). Practices will receive letters from their local Medicare Administrative Contractor (MAC) through the end of May. The mailings will include three documents: a general information letter, participation information, and list of frequently asked questions.

The letters inform physicians as to whether the group and the individuals within the group are exempt from the MIPS reporting requirements based on their clinician type in 2017 or if they fall below the low-volume threshold. Eligible clinician types include: MD, DO, NP, PA, CNS, and CRNA. Clinicians are considered below the low-volume threshold if during the determination timeframe they billed less than $30,000 in Medicare allowed charges or provided care to fewer than 100 Medicare patients. CMS uses both historical claims data and data from the performance period to make this determination. The letters do not contain information on a clinician’s Advanced Alternative Payment Model (AAPM) status or hospital-based determinations.

Letters are distributed at the practice level, but will contain information on each individual associated with the tax identification number (TIN). If a practice has decided to report as a group, all clinicians within the TIN will be included in the reporting, even if a clinician falls below the threshold as an individual. Practices should review the letters and determine if they will report as individuals or as a group. Clinicians practicing in multiple TINs will need to verify their participation status with each practice.

Participation in MIPS requires clinicians and groups to report data in four performance categories in 2017 in order to avoid a negative payment adjustment in 2019.

– Erin Solis, Regulatory Compliance Strategist at the American Academy of Family Physicians


Posted at 03:28PM Apr 27, 2017 by David Twiddy | Comments [0]

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The views expressed here do not necessarily reflect the opinions of FPM or the AAFP. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. All comments are moderated and will be removed if they violate our Terms of Use.

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