Outpatient Facility Coding Alert - 2017 Issue 10
MACRA: Are You Eligible to Report Measures in a Virtual Group? Find Out Here
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Article Overview
This article explains CMS updates related to MACRA, MIPS, and the Quality Payment Program for smaller and solo practices. It focuses on eligibility concepts, proposed Virtual Group participation, low-volume thresholds, reporting categories, timing, and the organizations and resources involved in the 2018 proposal process. The piece is relevant to clinicians, practice managers, and coding or compliance professionals tracking Medicare payment program changes.
Why This Topic Matters
It helps readers understand whether their practice may be affected by MACRA/MIPS participation requirements and whether the proposed Virtual Group structure could be relevant to their reporting strategy and compliance planning.
Article Sections
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Background
Introduces the broader payment-program transition and the reason Virtual Groups were created in the MACRA/QPP framework. It sets up the article’s focus on smaller practices and the proposed 2018 guidance.
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Peruse New MIPS Status Criteria for Virtual Clarification
Summarizes the proposed updates to MIPS participation thresholds and the general method CMS uses to determine low-volume status. It also references the timeline for evaluating participation eligibility.
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What Are Virtual Groups?
Describes the proposed Virtual Group participation model for smaller practices and how CMS presents the option within the 2018 rulemaking. It also notes related reporting categories and formation concepts.
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Reality
Discusses stakeholder concerns, uncertainty around implementation, and the need for additional clarification in the proposal. It includes broader compliance and operational issues raised by professional groups and advisers.
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Deadline
Covers the timing of the election process and the reporting-year deadline mentioned in the article. It also points readers to CMS and support-network resources for assistance.
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Resources
Lists external CMS reference materials and support resources associated with the proposal and small-practice assistance.
What You Will Learn
- How MACRA and MIPS relate to the Quality Payment Program
- What CMS means by a Virtual Group for smaller practices
- Which general eligibility and timing issues affect participation decisions
- What broad reporting categories are associated with the proposed model
- What kinds of policy and compliance questions stakeholders raised
Who Should Read This
- Medicare Part B providers
- Solo practitioners
- Small group practices
- Practice managers
- Compliance staff
- Medical coding and billing professionals
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