Tagged with MIPS Merit-based Incentive Payment System

CMS Releases Quality Payment Program Proposed Rule

On June 20th, CMS released its 2018 Medicare Quality Payment Program (QPP) proposed rule. Officially titled, “CY 2018 Updates to the Quality Payment Program,” the rule includes key policy updates that seek to streamline reporting requirements and simplify participation under the Merit-Based Incentive Payment System (MIPS) [Track 1] and the Advanced Alternative Payment Model (Advanced APM) [Track 2] pathways created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

End-Stage Renal Disease Proposed 2018 Policy and Payment Rate Changes

CMS has issued a proposed rule that would update payment policies for the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS). The ESRD PPS proposed rule is one of several for CY 2018 that reflect a broader strategy to relieve regulatory burdens for providers; support the patient-doctor relationship in healthcare; and promote transparency, flexibility, and innovation in the delivery of care.

FL – State Legislators Approve $83B Budget

Florida House and Senate leaders have agreed to approximately $650 million in cuts to hospital payments through Medicaid. The state plans to cut its share of Medicaid payments by $250 million in the upcoming budget, which reduces federal matching dollars by more than $400 million.

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

CMS has sent over 800,000 letters to clinicians, with notification that they will not be evaluated under the 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 Releases Approved 2017 MIPS Registry List

CMS has released the 2017 list of approved qualified registries. Physician practices may utilize these third-party vendors to report individual or group data for the Quality, Advancing Care Information, and Improvement Activities categories of the Merit-Based Incentive Payment System (MIPS) in order to avoid a -4% penalty and potentially earn a small bonus in 2019.

CMS Updates cEQM Table for ECs and EPs for 2017 Performance Period

CMS has published an updated table accompanying the 2016 eCQM specifications for the 2017 performance period. The updated table removes the previous meaningful use domains and now aligns with the domains listed in CY 2016 Medicare Physician Fee Schedule, as well as the MIPS and Advanced APM tracks of the Quality Payment Program.

Another Step Toward Value-Based Reimbursement

CMS Acting Administrator Andy Slavitt is urging healthcare and political leaders to continue value-based care progress made under the Affordable Care Act, including value-based care progress after MACRA implementation through universal coverage, the CMS Innovation Center, interoperable health IT, and patient-centered care.

PTAC Now Accepting APM Proposals

The Physician-Focused Payment Model Technical Advisory Committee (PTAC) was established earlier this year by MACRA and is now accepting proposals for alternative payment models (APMs).

MACRA Final Rule Released

CMS has published the Final Rule implementing the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The Rule finalizes provisions for participation in the new Medicare Quality Payment Program (QPP) which requires eligible physicians to begin reporting data under the Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs) in 2017.

ASCP Resists Proposed Pathology Cuts

The American Society for Clinical Pathology (ASCP) recently urged CMS to reduce the pathology cuts in its proposed 2017 Physician Fee Schedule.

All Payer ACO Model Receives Tentative Approval

Vermont has been granted tentative approval to establish an all-payer reimbursement system. If granted final approval, the All Payer Accountable Care Organization (ACO) Model would be effective for five years beginning January 1, 2017.

Pathology and MIPS in 2017

Almost all pathologists will need to participate in MIPS in 2017 or face a penalty in 2019. The 2 new “partial” options from CMS may make that easier for 2017, but they don’t change the basic direction. Preparing now is the prudent course.

CMS Adds Flexibility to MACRA Quality Reporting

CMS is adding 2 more options for quality reporting in 2017. They provide more flexibility for providers to comply with MACRA requirements. By submitting partial data, or partial year data, a practice can avoid penalties.