MACRA AND MIPS

This seems to be one of the hot topics this summer so I thought a quick bit of clarification would be in order for all our subscribers.  Here are a few highlights to explain what these two new acronyms mean to you, the phlebology practice.

 

1.  Currently MACRA is a proposed rule only. The final rule has not been released by CMS and until it is the any of the proposed guidelines can be changed.  The final rule should be released no later than 11/01/2016.

 

2.  This proposed system would replace the current Meaningful Use (MU) and PQRS reporting system by effectively combining them.  The measures you currently report on would essentially stay the same, they would just be under the “new and improved” system.

 

3.  Unlike MU and PQRS, which is an all or nothing system, MIPS would allow for partial credit to be assigned to a practice for partial participation. I know reporting has been a challenge for a small niche specialty in the past.  This would allow practices to report on what they can and stave off major payment penalties.  No, you may not receive an increase in payment, but you may also not take a large reduction either.  It would allow the phlebology practice the opportunity to remain payment neutral.

 

4. Measures have not been released yet and will not be until the final rule is released.  This means that until they are out there, you will not be able to choose which ones work for your practice.

 

5. The current implementation date is 01/01/2017, but this may be delayed due to the fact that the final rule will not be released until October at the earliest.  The first payment modification whether good or bad will begin in 2019 barring any delays.  CMS has released a report dated 09/08/16 about the “pick your pace” program.  See more details at https://blog.cms.gov/2016/09/08/QualityPaymentProgram-PickYourPace/

 

6.  Only Medicare patients and Medicare reimbursement are impacted by this program.

 

In short, if you are already reporting for MU and PQRS, what you currently do will likely not change much, and if you even try to report you can mitigate the negative impact this may have on your Medicare payments.

 

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