DocsInk - MACRA - 2018

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MACRA - Year Two - 2018. Fee for Service Pay for Reporting Pay for Performance The Journey to Healthcare Payment Reform
  MACRA Fee -for -ServicePay -for -ReportingPay -for - Performance Year Two -2018 The Journey to Healthcare Payment Reform  MACRA Timeline April, 2015 ã Congress passed the Medicare Access and CHIP Reauthorization Act of 2015 April, 2016 ã Department of Health and Human Services issued a Notice of Proposed Rulemaking for MACRA October, 2016 ã CMS released the Final Rule which was published in the Federal Register on 11/4/2016 January, 2017 ã First Quality Payment Program performance year begins January, 2018 ã Second Quality Payment Program performance year begins  MACRA Highlights ã Repealed Medicare’s Sustainable Growth Rate (SGR) physician fee schedule formula ã Replaced / Consolidated existing PQRS, Meaningful Use and Value-Based Modifier reporting programs ã Established the new value based reimbursement system called the Quality Payment Program (QPP)  Eligible for Quality Payment Program (QPP) Reporting in 2018 Individuals and Groups Consisting of the Following Eligible Providers: ã Physician (MD, DO, DMD, DDS) beyond 1 st year of Medicare Part B participation ã Physician Assistant ã Nurse Practitioner ã Clinical Nurse Specialist ã Certified Registered Nurse Anesthetist Meeting the Following Thresholds During 1 of 2 Determination Periods: Sept. 1, 2016  – Aug. 31, 2017 OR Sept. 1, 2017  – Aug. 31, 2018 (Includes a 30-day claims runout) ã Bill Medicare more than $90,000 of allowedcharges a year (Medicare Advantage claims do not apply to the required threshold) ã Provide care for more than 200 Medicare patients a year ( Medicare Advantage patients do not apply to the required threshold) ã It is estimated that 35% of Medicare clinicians will fall below the volume participation threshold in 2018, creating a more competitive program
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