Quality Payment Program Articles and Resources

News and Important Information

Quality Measures Finalized for 2019

The Money in MIPS

The Quality Payment Program is Medicare's performance based payment system for Medicare Part B services. Providers may participate by choosing one of the following two tracks:

  1. The Merit-based Incentive Payment System (MIPS)
  2. Advanced Alternative Payment Models (APMs)

CLICK HERE to check your participation status, research applicable measures, and to review guidance on MIPS, APMs, etc.

CLICK HERE to go to CMS' new QPP Resource Library.

Additional information regarding this program can be found in a specialty-specific Reimbursement Guide available in the online store.

 

General Links and Resources

QualityNet News

QualityNet News

Select the title to see a summary and a link to the full article.

Quality Measures Finalized for 2019

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CMS recently announced that the quality measures for 2019 have been finalized. There are new eligible clinicians so be aware of how that may affect your organization. New ECs are: Physical therapists Occupational therapists Qualified speech-language pathologists Qualified audiologists Clinical psychologists Registered dietitian or nutrition professionals The following are changes to Electronic Clinical Quality Measures (eCQMs) available ...

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Are you Ready for CMS' 2019 Medicare Physician Fee Schedule Final Rule?

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The waiting is over, the Final Rule for CMS' 2019 Medicare Physician Fee Schedule (MPFS) is available - all 2,379 pages for those looking for a little light reading. As anticipated, there are some pretty significant changes. Most of us were carefully watching the proposed changes to the Evaluation and ...

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Small Practices are Affected by MIPS Increased Thresholds

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We recently heard about a small practice that had been faithfully submitting all the required “G” codes for the Quality Payment Program (QPP) only to discover that for 2018 they are excluded from MIPS because the low volume threshold increased from $30,000 in Part B allowed charges or 100 Part ...

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How Does the Physician Compare Website Affect You?

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The physician compare website may not be working quite the way you think it is. Not all providers will have rankings showing up for them. Physician compare lists basic information, but quality measure information was not added until this year (2018) and not all quality measures are included in the ...

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The Money in MIPS

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Seema Verma, Administrator of the Centers for Medicare and Medicaid Services (CMS), recently announced that 91% participated in the first year of the Quality Payment Program (QPP), barely squeaking by their goal of 90%....

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Using a 2015 Certified EHR in MIPS Year 2

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The following information is from BC Advantage. As of Dec 31, 2017, Acumen EHR v8.0 achieved Office of the National Coordinator for Health Information Technology (ONC-Health IT) 2015 edition certification! What's a 2015 CEHRT?A CEHRT (Certified EHR Technology) is defined by CMS specifically for their incentive payment programs such as...

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Quality Payment Program in 2018

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I checked the government website to see if I am an eligible clinician and it says that I am not. I just don't want to get blindsided with a letter saying I will be penalized. Is there anything you would suggest or recommend that I do now to protect myself from future penalties. Thank you

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Appropriate Use Criteria for Advanced Diagnostic Imaging Services - 2018 Final Rule

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What is the AUC program? From the CMS website: Section 218(b) of the Protecting Access to Medicare Act of 2014 amended Title XVIII of the Social Security Act to add section 1834(q) directing CMS to establish a program to promote the use of appropriate use criteria (AUC) for advanced diagnostic imaging ...

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Why You Should Stop Using ROM as an Outcome Measure

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We received this email from a chiropractic colleague: “I recently attended a continuing education seminar accredited by a chiropractic college. The presenter was talking about outcome measures and highly recommended cervical and lumbar range of motion (ROM) as a good outcome measure for patients with spinal conditions. But I am hesitant to use ROM, because it seems to be inconsistent with a patient’s status.” What does the current research demonstrate?

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Four Final Rules Affecting CMS Payments for 2018

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It’s a season for changes. CMS just finalized four rules which directly impact the following payment systems: Physician Fee Schedule Final Policy, Payment, and Quality Provisions for CY 2018 Hospital OPPS and ASC Payment System and Quality Reporting Programs Changes for 2018 HHAs: Payment Changes for 2018 Quality Payment Program Rule for Year 2 This ...

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New Payment Rulings Could Affect You

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Fall has always been the season for CMS fee changes and on November 2, 2017, CMS announced the finalization of four rules which directly impact the following payment systems: Physician Fee Schedule Final Policy, Payment, and Quality Provisions for CY 2018 Hospital OPPS and ASC Payment System and Quality Reporting Programs Changes ...

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Payment Rulings and Small Provider Practices

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Fall has always been the season for CMS fee changes and on November 2, 2017, CMS announced the finalization of four rules which directly impact the following payment systems: Physician Fee Schedule Final Policy, Payment, and Quality Provisions for CY 2018 Hospital OPPS and ASC Payment System and Quality Reporting Programs Changes ...

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Does Every Visit Need to Document Quality and Quantity of Pain & Update the Treatment Plan?

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Does every single visit need to document quality and quantity of pain and an update to the treatment plan?

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Last Chance to Start Reporting MIPS

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MIPS is a program that allows Medicare to collect data from providers about high quality low cost care that uses technology effectively. There are four categories and providers need to learn about the available measures so that they can pick the ones that make them look the best.

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American Chiropractic Association Comments on MACRA 2018 Proposed Rule

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Arlington, Va. - The American Chiropractic Association (ACA) recently submitted comments to the Centers for Medicare and Medicaid Services (CMS) in response to the federal agency's proposed rule changes to the Quality Payment Program (QPP) for 2018. QPP is a new payment model for physicians, including chiropractors, created by the Medicare Access and CHIP ...

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Opting Out of MIPS & MACRA

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Question: Is it true that I can opt out of MIPS & MACRA if my part B charges are less than or equal to $30,000? If so, are the charges based on covered Medicare charges (98940, 98941, 98942) or all charges sent to Medicare? Some patients want non-covered charges sent to Medicare too.

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Quality Reporting is not Just for CMS

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If you thought that quality reporting is just for CMS, you are wrong. Other payers recognize the need to establish quality metrics.

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How to Report MIPS

If eligible, you need to start reporting for MIPS by October 2th, 2017. Do you know who is exempt? Are you familiar with the quality measures that apply to chiropractors? Do you understand how to report on the Advancing Care Information or Improvement Activities? Don’t worry, Dr. Gwilliam has done all your homework and, in this presentation, you will get the crib notes containing just what you need to know. You don’t need to feel overwhelmed with Medicare regulations, you just need to know what to do.

Watch the video →

How to Convert Your Medicare Patients to Cash to Avoid the Penalties of MACRA

The #1 concern reported by CMS about chiropractors is that, as a profession, we do a poor job of understanding maintenance care. Of course, that is THEIR definition of maintenance care. When you better understand the rules of medical necessity in Medicare, you begin to see what they are talking about. The truth is that there is a “gray” area between the distinct “white” of active treatment and the “black” of maintenance treatment, and that gray area is confusing when defining “covered” vs. “not covered” chiropractic care in Medicare. Join us to find out the following critical information in time for the MACRA Section 514 implementation January 1, 2017: Find out exactly what Medicare deems as maintenance care and how to recognize it with our patients Learn what your options are for treating your Medicare patient’s maintenance care for cash Hear scripting that is vital to your patient understanding what’s going on with their coverage, or lack thereof Properly document the difference between active and maintenance care Better manage those little incidents that come up for chronic, Medicare patients

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Mighty MACRA!

Mighty MACRA!

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