On June 20th, The Centers for Medicare and Medicaid Services (CMS) released a proposed rule which makes annual updates to the Quality Payment Program created under the Medicare Access and CHIP Reauthorization Act of 2015. Under the QPP, eligible clinicians can participate in either the Merit-based Incentive Payment System (MIPS) or an Advanced Alternative Payment Models (Advanced APM).

Similar to the 2017 reporting year, CMS is proposing for 2018 to be a transition year. However, CMS is proposing an incremental increase to the reporting and participation requirements from 2017.

Because the QPP brings significant changes to how clinicians are paid within Medicare, CMS is continuing to go slow and use stakeholder feedback to find ways to streamline and reduce clinician burden.  Based on this feedback, CMS established transition year policies from the clinician perspective, such as:

  • Giving clinicians the option to choose how they’ll participate (known as Pick your Pace)
  • Having a low-volume threshold that exempts many clinicians with a low volume of Medicare Part B payments or patients
  • Allowing flexibilities for clinicians who are considered hospital-based or have limited face-to-face encounters with patients (referred to as non-patient facing clinicians)

CMS does have proposals for Year 2 underway, but because of the variables, I think we should stick with Year 1 for now and try to absorb the details emerging soon.

Medical Business Office, Inc. your professional and trusted Medical Billing Company aka Revenue Cycle Management Service can assist with the steps required to prepare for this transition.  Give us a call at 573.634.7155.