The Centers for Medicare and Medicaid Services (CMS) recently released a proposed rule for year two of the Quality Payment Program, a component of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The new rule includes more flexible options for taking part in either the Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Model (APMs).
Several of the changes aim to offer exemptions to providers at small practices who might otherwise be administratively burdened by participation in the program. Some of the more significant changes proposed for the 2018 MIPS reporting year are as follows:
- Low-Volume Threshold: Increase the threshold to exclude providers from having to participate in MIPS if they bill ≤$90,000 in Medicare Part B allowed charges OR see ≤200 unique Medicare Part B beneficiaries per year. Currently the program excludes clinicians or groups with ≤$30,000 in Medicare Part B allowed charges OR ≤100 unique Medicare Part B beneficiaries per year.
- Virtual Groups: Allow solo practitioners, and groups of 10 or fewer clinicians, to come together “virtually” with at least one other solo practitioner or small group for participation in one MIPS performance year.
- Certified Electronic Health Record Technology (CEHRT): Allow providers to use either the 2014 or 2015 Edition of CEHRT, as well as provide a new bonus for using the 2015 Edition CEHRT.
Learn more about the potential changes by reading the CMS fact sheet about the Proposed Rule for Quality Payment Program Year 2. Comments on the proposed rule are due Aug. 21. When commenting, refer to file code CMS 5522-P.
Additional resources are available at the Payment Reform page of the Evolve Sleep website, including a MACRA webinar that provides more details about the Quality Payment Program.
