decisionhealth Newsletters, Part B News - 2017 Issue 7 (July)
Under QPP, virtual groups not expected to get ancillary services exception
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Article Overview
This premium article discusses a Quality Payment Program proposal topic involving virtual groups, physician self-referral, and how CMS frames the relationship between virtual group participation and Medicare legal structure. It is relevant to coders, compliance staff, and practice administrators who need to understand the regulatory context behind virtual groups under MIPS and the broader Stark law framework.
Why This Topic Matters
The article helps readers understand why virtual groups are treated differently from formally organized group practices for Medicare compliance purposes and why that distinction matters in self-referral discussions.
What You Will Learn
- How CMS discusses self-referral in the context of virtual groups under QPP
- How virtual groups are described in relation to Medicare group practice concepts
- Why the Stark law framework is relevant to the discussion of virtual groups
- How compliance concerns intersect with MIPS reporting arrangements
Who Should Read This
- Medical coders
- Compliance officers
- Practice administrators
- Physician group managers
- Healthcare attorneys
Code Ranges Discussed
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