CMS gives over 800K Physicians Reprieve from MACRA Reporting in 2017

May 2017 ~

CMS has sent over 800,000 letters to clinicians, with notification that they will not be evaluated under the Medicare Access and CHIP Reauthorization Act’s (MACRA) Merit-based Incentive Payment System (MIPS) in 2017. Federal officials predict only about one-third of clinicians will have to file quality reports this year under the new Medicare payment system.

CMS officials have stated that 418,849 clinicians will be required to participate in quality reporting this year to avoid penalties under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and a total of 806,879 clinicians have received letters confirming that they will not be required to comply with this year’s MACRA reporting requirements in 2017.

According to CMS, exempted physicians include:

  • clinicians who bill Part B less than $30,000 or care for fewer than 100 Part B enrollees annually
  • clinicians new to Medicare during 2017
  • providers who have implemented a MACRA-compliant Advanced Alternative Payment Model

Under MIPS, physicians can earn a bonus or penalty of 4% of their reimbursement in 2019. Medicare reimbursement in 2019 will be based upon physician performance in 2017 in four performance categories: quality, resource use, clinical practice improvement and “advancing care information” through use of health information technology.

As an aid, the agency has released an online lookup tool to allow clinicians to easily determine whether they must participate [in the MIPS] this year.


Source(s): Leavitt Partners; Modern Healthcare; CMS; Medscape; EHRIntelligence; Healthcare DIVE: Payer; Modern Healthcare; HFMA