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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. ...

CMA updates MACRA preparation checklist

The California Medical Association’s (CMA) Center for Economic Services has published an update to its Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) preparation checklist. The checklist, “MACRA: What Should I Do Now to Prepare?”, is available in CMA's MACRA resource center at www.cmanet.org/macra.  CMA published this important checklist to help physicians understand MACRA payment reforms and what they can do now to start preparing for the transition. Also available in the MACRA resource center is an overview of MACRA, and a comprehensive list of tools, resources and information ...

CMS to remove SSNs from all Medicare cards by April 2019

The Centers for Medicare & Medicaid Services (CMS) will remove social security numbers (SSNs) from all Medicare cards by April 2019, as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). As part of the Social Security Number Removal Initiative, a new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) for all Medicare transactions. The MBI is confidential like the SSN, and should be protected as personally identifiable information.  By replacing the SSN-based HICN on all Medicare cards, private health care and ...

CMS awards $100 million to help small practices succeed

The Centers for Medicare & Medicaid Services (CMS) has awarded $20 million to 11 organizations for the first year of a five-year project to provide on-the-ground training and education about the Quality Payment Program, established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), for clinicians in individual or small group practices. CMS intends to invest up to an additional $80 million over the remaining four years. Among the awardees are three California organizations: IPRO in San Francisco, Health Services Advisory Group in Glendale and Burlingame, and Qualis ...