Category: Value Based Payment/MACRA
The Medicare Access and CHIP Reauthorization Act (MACRA) is a transformative law that will ultimately lead the American health care system away from a fee-for-service model and towards a new risk-bearing, value-based, coordinated care models. MACRA will drive payment and delivery reform across the payer mix for the foreseeable future in an attempt to lessen the overall burden of ever-climbing healthcare costs in the US.
Anyone who bills Medicare Part B for more than $30,000 or sees more than 100 Medicare Part B patients must participate in MIPS/MACRA. Eligible Clinicians include: MD, DO, NP, PA, CNS, CRNA.
The good news: Kentucky REC is here to help. We have been awarded a grant from CMS to establish the Quality Payment Program Resource Center™ to provide FREE help to eligible clinicians as they navigate participation in the CMS Quality Payment Program focused on supporting … Read More »
CMS has followed up the MIPS Notification letters with a helpful tool to look up provider eligibility by individual NPI. To access the NPI lookup tool, go to http://qpp.cms.gov and click on the green “Check Now >” button as seen in the screenshot below.
From there, you can enter the provider’s individual NPI to check their eligibility. This tool should help anyone who is unsure about their provider’s status with MIPS for 2017. If CMS data reflects that the provider is required to submit data to MIPS, the following screen will state” “Included in MIPS; (Providers Name) must submit data to MIPS by March 2018″ along with a new green button labeled “What Can I Do Now?”.
If the provider isn’t required to submit data to MIPS for 2017, the screen will show: “Exempt from MIPS; (Provider Name) is not required to … Read More »
The Centers for Medicare & Medicaid Services is reviewing claims and letting practices know which clinicians need to take part in MIPS, the Merit-based Incentive Payment System. MIPS is an important part of the new Quality Payment Program. In late April through May, practices will get a letter from the Medicare Administrative Contractor that processes Medicare Part B claims. This letter will tell the participation status of each MIPS clinician associated with the Taxpayer Identification Number or TIN in a practice.
Clinicians should participate in MIPS for the 2017 transition year if they bill more than $30,000 in Medicare Part B allowed charges a year AND provide care for more than 100 Part B-enrolled Medicare beneficiaries a year.
The Quality Payment Program intends to shift reimbursement from the volume of services provided toward a payment system that rewards clinicians for their overall … Read More »
Physician Quality Reporting System (PQRS) Groups Must Register to Utilize the CMS Web Interface and/or CAHPS for MIPS Survey by June 30, 2017
Groups participating in the Merit-based Incentive Payment System (MIPS) track of the Quality Payment Program are not required to register, except for groups that intend to utilize the CMS Web Interface and/or administer the Consumer Assessment of Health Providers and Systems (CAHPS) for MIPS survey. To register, please visit the Quality Payment Program website. The registration period is from April 1, 2017 through June 30, 2017.
Under MIPS, a group is defined as a single Taxpayer Identification Number (TIN) with two or more eligible clinicians (including at least one MIPS eligible clinician), as identified by their National Provider Identifiers (NPI), who have reassigned their billing rights to the TIN. Eligible clinicians who participate as a group will be assessed … Read More »
On October 14, 2016, CMS released its final rule for the Quality Payment Program (QPP) authorized by the Medicare Access and CHIP Reauthorization Act (MACRA).
Kentucky REC presented a MACRA Overview webinar to help organization’s understand how this will impact the way they deliver care.
To listen to the webinar, please click here.
The following questions were asked on the webinar. We have answered the Frequently Asked Questions below.
Please note: If you asked a question and do not see an answer here, please contact us directly and we will be more than happy to speak with you.
1. Are anesthesiologist excluded from MIPS?
Anesthesiologist may be exempt from participating in the MIPS program or certain categories of the program dependent on the place of service codes billed. Once CMS has the NPI lookup feature available you will be able to use this tool to find out for … Read More »