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    Looking ahead at MACRA/MIPS reporting for physicians

    More than 800,000 physician practices got a on MACRA compliance from the Centers for Medicare & Medicaid Services (CMS) in May. But practitioners shouldn’t breathe easy just yet.


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    The break is only for certain providers and it only applies for 2017, which was slated to be a transition year anyway. Physicians who want to avoid future penalties should start preparing now to comply with MACRA and MIPS reporting requirements in 2018 and beyond.

    Understand 2017 exemptions

    To aid in the transition, CMS had previously announced reduced reporting requirements in 2017 for physicians and healthcare organizations participating in the Merit-based Incentive Payment System (MIPS). Those who fail to collect and report a minimum amount of performance data this year could face a 4% negative payment adjustment on reimbursements in 2019 — with that penalty amount set to increase in future years.

    Under the latest exemptions, physicians with $30,000 or less in Medicare charges and 100 or fewer unique Medicare patients per year, as well as those who are new to Medicare in 2017, will not be evaluated under MIPS this year, and should have received a letter from CMS stating such. If you are now exempt, count yourself lucky.


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    However, that still leaves close to 419,000 clinicians who are supposed to submit MIPS data for 2017. Those eligible providers are not just physicians—also included are some nurse practitioners, physician assistants, clinical nurse specialists and certified registered nurse anesthetists.

    Understand MACRA reporting options

    Understanding the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is not complicated. It was designed to streamline value-based programs, including Meaningful Use, Physician Quality Reporting System and Value Modifier.  

    MACRA outlined : the Merit-based Incentive Payment System (MIPS) and the advanced Alternative Payment Model (APM). Most physician practices are expected to use MIPS to comply.

    Next: Avoiding negative Medicare payment adjustments

    Kevin N. Fine, MHA
    Kevin N. Fine, MHA, is a director of healthcare advisory services in the Miami office of Kaufman Rossin, one of the Top 100 CPA and ...


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