CMS will be sending letters to physician practices throughout the month of May with important, practice-specific information regarding eligibility to participate in the Merit-Based Incentive Payment System (MIPS) at the group/individual level for the performance year 2017.

Everyone Taxpayer Identification Number (TIN) should enrolled to participate in the Medicare program will be receiving a letter that includes a summary of the Quality Payment Program (QPP),

The Following steps towards participation and reporting, and the exemption eligibility guidelines:

1. Being a less volume clinician: Identified by using historical Medicare claims data and defined by having less than $30,000 in annual Medicare Allowable charges or by treating fewer than 100 Medicare patients.
2. First-year Medicare enrolled clinicians.
3. Not being one among the categories of clinicians included in the program’s first year, i.e. therapists, audiologists, and others.
4. Participants in certain Advanced Alternative Payment Models (APM), if participation is sufficient to meet certain thresholds.

If you find that your questions regarding MIPS are still left unanswered, Please give us a call or send an email at +1(302) 613-1356 or support@wonderw.com

MIPS Participation Attachments:

The true value of the letter is found in its two attachments which contain information specific to you and your practice.

Attachment A: It contains the Eligibility /Exemption status for the TIN and each individual provider enrolled under the TIN. This can be used to help you determine whether your group will be required to participate in MIPS for performance year 2017 and if you should report as a group or as individual clinicians.

NOTE:  If your group chooses to report as a group, MIPS assessment will be based on All Individuals in the group. This will not take into consideration any providers who would be individually exempt from participation.

Attachment B: It contains CMS’s best effort to answer some of the many questions you may have about the Quality Payment Program, its two tracks: MIPS and APM, and how you should prepare for participation.

If you have not received your letter from CMS, you can also look up your MIPS eligibility on the QPP website at: http://qpp.cms.gov/learn/eligibility

More information on MACRA, MIPS can be found on our blog at http://localhost/main-site-update/among-uninformed-macra-mips/

Approximately 50 percent of doctors reported they have not yet heard of the payment reform Medicare Access and CHIP Reauthorizing Act of 2015 (MACRA).

Are you not aware about on MACRA / MIPS? Find out why it matters:

What is MACRA?

MACRA combines parts of the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VBM), and the Medicare Electronic Health Record (EHR) incentive program into one single program called the Merit-based Incentive Payment System, or “MIPS”.

According to the Centers for Medicare and Medicaid Service (CMS), MACRA is an important stepping stone in the switch to value-based care. It also gives clinicians two options for linking payments to value:

1. Merit-Based Incentive Payment System (MIPS): According to CMS, MIPS measures physicians on quality, resource use, clinical practice improvement and meaningful use of electronic health records.
2. Alternative Payment Models (APMs):Examples of APMs include Accountable Care Organizations (ACOs) and Patient Centered Medical Homes (PCMHs). By using these models, providers receive lump-sum payment incentives.

To Know more on MACRA / MIPS http://localhost/main-site-update/macra-mips/

What is MIPS?

Merit-based Incentive Payment System, also known as MIPS, streamlines three previous pay-for-performance programs and adds a fourth component to promote the ongoing improvement and innovation to clinical activities.

MIPS will annually measure Medicare Part B providers in four performance categories to derive a score ranging zero to one-hundred, which can significantly change a provider’s Medicare reimbursement in each payment year.

There are four MIPS performances categories are as follows:

1. Quality (replaces PQRS and parts of VBM).
2. Advancing Caring information (replaces EHR meaningful use).
3. Clinical Practice Improvement Activities (New category).
4. Resource Use.

“Medicare Access and CHIP Reauthorizing Act of 2015. The act was signed into law in early 2015 and makes substantial changes to the government’s health care payment system. The Sustainable Growth Rate formula for determining provider payments and changing the Medicare physician fee schedule by establishing two new options for reimbursement: The Merit Based Incentive Payment System (MIPS) and Alternate Payment Models (APMs).”