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CMS releases proposed Medicare physician fee schedule for 2018

The Centers for Medicare & Medicaid Services (CMS) recently released the proposed 2018 Medicare Physician Fee Schedule. The California Medical Association (CMA) is pleased to note that there are a number of positive proposed changes that would help physicians improve patient care. CMS is also soliciting ideas from physicians to reduce Medicare and Medicaid regulatory hassles. Highlights of the proposed rule include:  Request for information on regulatory relief: CMA applauds CMS’ invitation for physicians to submit ideas for regulatory, policy, practice and procedural changes to improve the health care system to ...

CMA Open Payments data shows that only 5.6% of physicians looked at their records

The Centers for Medicare and Medicaid Services (CMS) announced last week that in 2016, only 5.6 percent of physicians nationwide reviewed their data under the Medicare Open Payments program. Under the Open Payments program, drug and medical device manufacturers are required to report their financial interactions with licensed physicians – including consulting fees, travel reimbursements, research grants and other gifts. Medicare publicly released calendar-year 2016 Open Payments data on June 30 following a 45-day period during which physicians were able to review their data and dispute errors. According to CMS, only 34,871 ...

Survey finds nation's physicians not ready to fulfill MACRA reporting requirements

Fewer than one in four physicians feel ready to meet the Centers for Medicare and Medicaid Services (CMS) Quality Payment Program (QPP) reporting requirements, according to a survey of 1,000 physicians conducted by the American Medical Association (AMA). QPP is the new physician payment system created by the Medicare Access and CHIP Reauthorization Act (MACRA). It replaces the fee-for-service reimbursement model with two paths to choose from: the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APM). Over half of those surveyed (56 percent) plan to participate in MIPS in ...

New video shows physicians how to avoid Medicare payment penalties

The American Medical Association (AMA) has published a short instructional video to help physicians avoid being penalized under the new Medicare Quality Payment Program (QPP). QPP is the new physician payment system created by the Medicare Access and CHIP Reauthorization Act (MACRA) and is administered by the Centers for Medicare and Medicaid Services (CMS). Because QPP is new this year, AMA and the California Medical Association (CMA) want to make sure physicians know what they have to do to participate in QPP’s “pick your pace” options for reporting. This is ...

Noridian to issue electronic Level 1 Medicare Redetermination Notices via web portal

Effective June 16, 2017, providers who submit their redetermination and/or reopening requests through the Noridian Medicare Portal (NMP) will now receive their Level 1 Medicare Redetermination Notices (MRNs) via NMP.  If a redetermination or reopening outcome results in a fully favorable (payable) determination, the remittance advice will provide details. For all other decisions in which providers receive an MRN, the determination letters will now be available through the Appeal Status Inquiry feature in NMP only. Practices that submit electronic reopening and redetermination requests should ensure that any assigned staff member is ...

Significant improvements in 2018 MACRA rule

The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that would make changes in the second year of the Quality Payment Program as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Though not perfect, the California Medical Association (CMA) is pleased that CMS has listened to physician feedback and has made changes that will significantly reduce the administrative burdens on physicians, particularly for small and rural practices.  Under the proposed rule, 2018 will be another transition year like 2017. This means that physicians ...

MIPS group reporting registration period ends June 30

Physician groups planning to use the Centers for Medicare and Medicaid Services (CMS) web interface or the Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient satisfaction survey data to satisfy requirements of the new Merit-Based Incentive Payment System (MIPS) must register by June 30, 2017. Please note that registration is only required if a group chooses to submit data using one of these two mechanisms. Groups do not need to register if they plan to submit MIPS data through other submission methods, such as a qualified registry, qualified clinical ...

CMS to issue MIPS participation status notices

Starting in late April, the Centers for Medicare & Medicaid Services (CMS) began notifying physicians whether they will be subject to Medicare's new Merit-Based Incentive Payment System (MIPS). MIPS is part of the new Medicare Quality Payment Program established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Providers with less than $30,000 in Medicare payments or fewer than 100 Medicare patients are exempt from the MIPS reporting requirements. Physicians who exceed this threshold are subject to MIPS and are encouraged to participate in MIPS for the 2017 ...

CMS delays reporting deadline for physician labs

The Centers for Medicare and Medicaid Services (CMS) has announced that it will delay the deadline for physician office-based laboratories to meet new reporting requirements. Qualified laboratories now have until May 30, 2017, to complete reporting of private payor payment data for clinical testing services, as required by the Protecting Access to Medicare Act (PAMA). Under PAMA, laboratories that meet revenue thresholds are required to report private payor payment rates and associated volumes for tests they perform that are paid on the Clinical Laboratory Fee Schedule (CLFS). CMS said it ...

CHPI publishes physicians' quality ratings for cycle 2

On March 22, 2017, the California Healthcare Performance Initiative System (CHPI) released its second cycle of physician quality ratings to the public. The ratings can be accessed at CHPI’s newly launched website, CAqualityratings.org, which allows consumers to search ratings on approximately 10,000 California physicians.  As previously reported in September 2016, approximately 13,000 physicians in California received their individual quality measurement scores for the second cycle of the CHPI quality rating program. The program rates physicians using claims data from Medicare fee-for-service, Anthem Blue Cross, Blue Shield of California and UnitedHealthcare. ...