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Mid-Week MACRA Minute – Improvement Activities Tips n Tricks

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Helping you put the MIPS pieces together each week! Improvement Activities: Tips ‘n’ Tricks We created a list of a few tips on the Improvement Activities performance category for 2017.  Remember, the Improvement Activities category counts for 15% of your 2017 MIPS Performance score. Tips ‘n’ Tricks: The maximum score for the Improvement Activities (IA) category is 40. Each Improvement Activity is weighted differently and the weight determines the points that you will receive for completing the activity:…
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Qualified Medicare Beneficiary (QMB) Indicator in the Medicare Fee-For-Service Claims Processing System

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QMB is a Medicaid program that assists low-income beneficiaries with Medicare premiums and cost sharing. Effective Date: For claims processed on or after October 2, 2017 Summary of Changes: Creates an indicator of Qualified Medicare Beneficiary (QMB) status in the claims processing systems. Beneficiaries enrolled in the QMB program are not liable to pay Medicare cost-sharing for all Medicare A/B claims. The new claims processing systems QMB indicator will trigger notifications to providers (through the…
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Mid-Week MACRA Minute – Quality Measure: Tips n Tricks

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Helping you put the MIPS pieces together each week! Quality Measures: Tips ‘n’ Tricks We created a list of a few tips on how to successfully attest for the Quality Measures performance category in the 2017. Tips ‘n’ Tricks: Quality Measures are NOT restricted by specialty. Only 1 reporting mechanism can be used to report the Quality Measures performance category of MIPS. Attest to more than one Quality Measure or Improvement Activity to provide additional…
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Mid-Week MACRA Minute – Quality Measure 226: Preventive Care and Screening: Tobacco Use

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Helping you put the MIPS pieces together each week! Quality Measure 226 – Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention CMS made some changes to Quality Measure 226 and we have highlighted those changes below. Description: Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user NEW DENOMINATOR/NUMERATOR CRITERIA…
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Changes to Alabama Medicaid RHC Billing Effective January 1, 2018

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Attention Independent Rural Health Clinic (IRHC) Alabama Providers: Effective January 1, 2018, Alabama Medicaid will no longer allow IRHC providers to bill a small range of services for the encounter rate. IRHCs will need to bill the actual procedure code for the services performed instead of billing a limited range of codes, such as 99211-SE and 99231-SE. IRHCs will need to refer to the CPT code book and bill the most appropriate code to reflect…
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Mid-Week MACRA Minute – PROPOSED Changes for 2018

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Helping you put the MIPS pieces together each week! Have you seen the PROPOSED MIPS changes for 2018? View the full PROPOSED Rule for the 2018 Performance Period at https://qpp.cms.gov/about/resource-library. The 60 day comment period on the proposed rule will end on August 21, 2017. Below are some of the highlights from the 2018 PROPOSED rule for MIPS: Raising the low-volume threshold to exclude individual MIPS eligible clinicians or groups who bill less than or equal to $90,000…
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Mid-Week MACRA Minute – Data Validation & Auditing

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Helping you put the MIPS pieces together each week! MIPS Data Validation and Auditing CMS is required by the Quality Payment Program Final Rule with comment, to provide the criteria they will use to audit and validate measures and activities for the 2017 transition year of MIPS for all performance categories: Quality, Advancing Care Information and Improvement Activities. According to CMS, data validation is the process of ensuring that a program operates on accurate and useful data. MIPS…
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PROPOSED 2018 MIPS and APM changes

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On June 20, 2017, the Centers for Medicare & Medicaid Services (CMS) released the PROPOSED RULE for the 2018 Quality Payment Program, which includes the Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs) participation options and requirements. The Medicare Access and CHIP Re-authorization Act of 2015 (MACRA) requires that the Quality Payment Program is reevaluated and updated annually. The proposed rule aims to simplify reporting requirements and offer support for doctors and clinicians…
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Mid-Week MACRA Minute – Quality Measures

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Helping you put the MIPS pieces together each week! MIPS Performance Categories: Quality Measures Quality Measures category replaces the Physician Quality Reporting System (PQRS). This category is 60% of your 2017 MIPS Performance score. In 2017 for the Quality Measures performance category, to earn an incentive (up to 4%), Eligible Clinicians (ECs) are required to report: Up to 6 quality performance measures; including one outcome measure If no outcome measure is available for your specialty or practice, choose…
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Updates to the ASC Payment Center & Billing Instructions for July 1

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Attention Ambulatory Surgical Centers: CMS released changes to the ASC payment center and billing instructions for various payment policies that will be implemented on July 1, 2017. Make sure your billing staff is aware of these changes before the update is released. Effective July 1, 2017: NEW Category lll CPT Code 0474T – Insj aqueous drg dev io rsvr – July 2017 ASC PI: J8 New Separately Payable HCPCS Codes  C9745 – Nasal endo Eustachian tube…
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Medicare Providers who have Never Attested – Easy Deadline Approaching To Avoid Penalty

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ATTENTION: Eligible Medicare Clinicians Who Have Never Successfully Attested If you are a Medicare clinician eligible to participate in the Merit Based Incentive Payment System (MIPS) in 2017, but have never successfully attested to Meaningful Use in previous years, you can still avoid the -4% penalty for 2018 AND the MIPS -4% penalty in 2019. That means you avoid a combined total of -8% in Medicare Part B penalties in the next 2 years! For…
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Mid-Week MACRA Minute – Improvement Activities

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Helping you put the MIPS pieces together each week! MIPS Performance Categories: Improvement Activities Improvement Activities is a new MIPS category that assesses how much you participate in activities that improve clinical practice. Improvement Activities (IA) is 15% of your 2017 MIPS Performance score. Reminder: This category does not require the use of a certified EHR. Plus, you may already be doing some of the activities. In 2017 for the improvement activities category, you will:…
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