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Medicare And Medicaid Services

The Centers for Medicare and Medicaid Services (CMS) had recently announced that the participation letters for the Quality Payment Program (QPP) would be sent to all the Eligible Clinicians starting late April through May. The Medicare Administrative Contractor (MAC), which processes the Medicare Part B claims of clinicians, will send these participation letters. Clinicians were very much upset and confused about the Merit-based Incentive Payment System (MIPS) participation and criteria and these letters will let them know if they have to take part or if they are exempted from MIPS.

These participation letters from MAC will let the clinicians know if they need to take part in MIPS or if they are exempted from the same as they fall below the threshold of low-volume provider. Those clinicians who billed less than thirty thousand dollars in the Medicare Part B charges or who offered care for hundred or less than hundred Medicare Part B enrollees in any of the last two years will be exempted from MIPS under the exception of low-volume health care provider.

CMS is planning to send the letters in the month of December in the coming years as this will let the providers know early if they are exempted from payment for the coming reporting year. Those providers who do not want to wait for the letter can visit the web page that is setup by CMS. In the webpage, medical billing companies and healthcare providers will be able to check if they need to submit data to the MIPS. To know the details, you will need to provide your ten digits NPI.

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Quality Payment Program

CMS has made 2017 a transition year for the MIPS. Therefore, the sense of urgency connected to knowing in advance if a clinician is exempted from paying has become less important. In the transition year, the Eligible Clinicians will be offered many participation tracks to choose from, which ranges from partial participation to full participation.

The payment adjustments for the year 2019, negative or positive, will largely be based on the data that was reported in 2017. However, experts say that those Eligible Clinicians who participate in any form will be able to avoid negative payment adjustments in the year 2019. Yet again, CMS said that only those Eligible Clinicians who do not report any data would get the maximum negative payment adjustment that is set to be at 4%.