With the launch of the Medicare Access and CHIP Reimbursement Act of 2015 (MACRA) earlier this year and the reporting aspect in full effect, CMS plans to tell doctors by the end of May if they must participate in MACRA’s Merit-based Incentive Payment System (MIPS).
MIPS is a central component of the Quality Payment Program and was suggested to be the MACRA track of choice for most participants during the early years of the rule’s implementation.
Who is required to participate?
All practices are required to participate in MIPS unless qualifying for an exemption:
- New practices: It’s your first year accepting Medicare payments
- Low volume: You bill less than $30,000 in Medicare per year or see fewer than 100 Medicare patients
- Qualified Participant in an APM: Examples include Medicare Shared Savings Program (MSSP), Comprehensive Primary Care Plus (CPC+), and the Next Generation ACO Model
During 2017, any practice making less than $30,000 in Medicare Part B reimbursements or with less than 100 Medicare patients are exempt. However, beginning in 2018, small practices who do wish to participate have the option of forming a virtual group of up to 10 clinicians to participate together in MACRA.
CMS has been reviewing claims, and throughout the month of May, practices will get a letter from the Medicare Administrative Contractor that processes Medicare Part B claims, letting them know which clinicians will be required to participate in MIPS.
Physicians can face penalties of up to 4 percent of their Medicare payments in 2019 if they fail to meet the MIPS requirements this year. Learn more about the requirements and what participating physicians need to do in 2017.
Elation Health is committed to making the transition to value-based care as uncomplicated as possible for every type of practice. If you are ready to take first steps in participating we are ready to help, equipped with resources to empower independent practices to participate stress-free. Contact us today if you need MACRA/MIPS support for your practice!