MACRA Minute May Newsletter

Piggy BankComing Soon: MIPS Eligibility Letters

Not sure whether your practice is eligible to participate in MIPS? You can put those worries to rest as CMS is sending notification letters informing practices of their provider’s eligibility for the 2017 MIPS program. Letters will be mailed no later than May 31, 2017, to the TIN representative specified in PECOS (please note letters will not be mailed to individual clinicians).

The letters have three parts:

  1. Main letter: Introductory information on QPP
  2. Attachment A: Lists participation status for each NPI associated with the TIN.
  3. Attachment B: Important Q&As

How is MIPS eligibility determined? 

MIPS eligibility is determined by Medicare Part B claims data from September 1, 2015, to August 31, 2016. Providers who bill $30,000 or less to Medicare or serve 100 or less Medicare patients are exempt from the program in 2017. 

Practices have the option to report at the individual or group level.

  • Group Level: Data for all providers listed in the TIN must be aggregated so the practice can be assessed and scored together.
  • Individual Level: Every MIPS-eligible clinician in the practice will individually report measures and activities. *Note: If your practice reports at the individual level, and you are not MIPS-eligible, you are exempt from participating in 2017.

sample MIPS participation status letter is available on CMS’ QPP website under “Educational Resources.”

TIN = Tax Identification Number; PECOS= Provider Enrollment, Chain, and Ownership System; NPI= National Provider Identifier.

Get to Know Your Registry

CMS recently provided a list of qualified registries eligible clinicians can use to report 2017 MIPS data. Clinicians and groups planning to submit data via a qualified registry are encouraged to review the list before making a selection.

What is a Qualified Registry?

A qualified registry is a CMS-approved entity that collects clinical data from MIPS-eligible clinicians (both individual and groups)and submits it to CMS on their behalf.

The list includes detailed information for each of the 2017 qualified registries, including: 1) contact information; 2) measures, activities, and performance categories supported; 3) services offered; and 4) costs incurred by their clients.

New to MIPS: Patient Relationship Codes

CMS is developing a list of patient relationship categories and codes to more accurately attribute patients to the providers responsible for their care.

This is new territory for CMS, as these categories/codes do not exist under current coding procedures (click here for more information).

What are patient relationship codes and how/when will I use them?

Per MACRA regulations, patient relationship codes must be reported on Medicare claims beginning in 2018. Codes will be used in 2018 to help:

  1. Providers better attribute the cost of caring for individual patients
  2. CMS more effectively measure cost, a major MIPS performance category

Mark Your Calendar

May 25

What: Telligen QPP-SURS Webinar

Time: 12 p.m. CST

Topic & Description: MIPS Survive & Thrive: Advancing Care Information

Now that you’re ready to conquer quality,* it’s time to meet the new MU (aka Advancing Care Information). In 2017, ACI is the second-highest scored category after quality. Even if you have attested to Meaningful Use in the past, this webinar will help you understand the nuances of this performance category. Registration is now open.

Now Available: *Conquering Quality

Clinicians unable to attend the April 27 “Conquering Quality” webinar can view the recording and slides on Telligen’s QPP website.

We’re Here for You…Contact Us Today!

Providers of every practice type, specialty, and size have access to free technical assistance to navigate the transition to the QPP.

Whether you are new to quality reporting or have significant experience with programs like PQRS and MU; there’s always room for improvement.

Contact Telligen today to assess your practice for QPP-readiness, and create a road map for achieving goals in 2017 and beyond.

QPP Contacts

  • Telligen Resource Center
    • Office Hours: Reach an advisor directly: Tuesdays 9-11 a.m. & Thursdays 12-1 p.m., CST
    • Call Us (Office Hours, CST): 515-453-8180
    • Call Us (Normal business hours, CST): 844-358-4021
    • Email Us: qpp-surs@telligen.com
  • National QPP Resource Center (CMS)
    • Phone: 866-288-8292
    • Email: qpp@cms.hhs.gov

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