Advocacy News

June 27, 2017

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AAOS to Comment on 2018 Quality Payment Program Proposed Rule

Bonefied News

Reminder: G-Code Reporting – Starts July 1!

Quality Payment Program Updates

Congratulations to Kay Kirkpatrick, MD - Officially Sworn in as State Senator!

AMA House of Delegates – Annual Meeting 2017

Political Graphic of the Week

State Corner: State Orthopaedic Societies Tackle Workers Compensation Issues

What We're Reading

5 Ways for Healthcare Providers to Get Ready for New Medicare Cards

New Resident PAC
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PAC Participation Leader Board by State

Thank You to Our Current Orthopaedic PAC Advisor’s Circle Members!

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Quality Payment Program Updates

QPP

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, and the Centers for Medicare & Medicaid Services (CMS) then replaced it with the Quality Payment Program. Remember – the Quality Payment Program has two tracks you can choose: Advanced Alternative Payment Models (APMs) OR the Merit-based Incentive Payment System (MIPS). AAOS has shared the details of QPP and MIPS, which can be found on our website, here: www.aaos.org/MACRA_QualityPaymentProgram/ and here: www.aaos.org/MACRA-DeliveryReform/.

Importantly CMS has designated 2017 as a transition year for quality reporting under MIPS, allowing providers to take advantage of the “Pick Your Pace” option in MIPS. There are four options during the “Pick Your Pace” transition period.

  • No reporting: incurs a -4% payment adjustment
  • Submit something to avoid a penalty: a single quality measure for a single patient qualifies
  • Submit partial year: submit data for a 90-day period
  • Submit a full year: submit data for full year

Those providers who submit partial or full-year data can potentially earn a positive payment adjustment. However, to avoid incurring a penalty, submission of a single measure is required. The American Medical Association (AMA) recently shared an educational tool, entitled “One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting,” which includes a short video offering simple instructions for reporting.

Additionally, CMS recently sent out letters to notify providers whether they had been slated to participate in MIPS. If you have not received a letter from CMS regarding MIPS eligibility, you may use an interactive tool on the CMS Quality Payment Program website to determine if they should participate in 2017. To determine your status, enter your national provider identifier (NPI) into the entry field on the tool which can be found on the Quality Payment Program website at https://qpp.cms.gov/. Information will then be provided on whether or not you should participate in MIPS this year and where to find resources.

Generally, you will participate in MIPS in 2017 if you bill Medicare Part B more than $30,000 a year AND see more than 100 Medicare patients a year. If you are new to Medicare in 2017, you do not participate in MIPS. You may also be exempt if you qualify for one of the special rules for certain types of clinicians, or are participating in an Advanced APM. To learn more, review the MIPS Participation Fact Sheet.

To get the latest information from CMS, visit the Quality Payment Program website. The Quality Payment Program Service Center may be reached at 1-866-288-8292 (TTY 1-877-715- 6222), available Monday through Friday, 8:00 AM-8:00 PM ET or via email at QPP@cms.hhs.gov.