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High Level Changes for the MIPS 2019 Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) recently issued its Proposed Rule for 2019 under the Quality Payment Program. In addition to changes within each performance measure category, there are some proposed high-level changes that practices should take notice.

2017 MIPS Feedback Reports are Available – Have You Reviewed Yours?

If your practice has not checked your 2017 Merit-based Incentive Payment System (MIPS) Feedback Report, it is suggested you do so as soon as possible. According to recent reports from the Medical Group Management Association (MGMA), there are issues related to “groups” being improperly assessed as “individual” reporters, despite being acknowledged by the Centers for Medicare and Medicaid Services (CMS) as group reporting at the TIN (Taxpayer Identification Number) level in preliminary feedback. Feedback Reports have replaced the Quality and Resource Use Report (QRUR).

The Impact of Therapies on the Genomics of a Tumor

As genomic panels are completed, and genetic mutations are identified, providers can decide on a treatment plan which would target the specific tumor or cancer cell mutations. Those targeted therapies can be one of several approved cancer treatments—hormone therapies, therapies which block a blood supply to a tumor, therapies which try to kill or destroy specific cancer cells or even immunotherapies which try to trigger the patient’s immune system to destroy those cancer cells.

MIPS 2019: Commenting on the Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) released the Proposed Rule for 2019 and practices are encouraged to comment on the changes here. Although the Proposed Rule states that all comments must be submitted by 5 p.m., Sept. 10, 2018, comments submitted electronically to www.regulations.gov will be accepted until 11:59 p.m. ET.

Overview of the 2019 Medicare Physician Fee Schedule (MPFS) Proposed Rule: Evaluation and Management Codes

Some of the biggest changes to the MPFS Proposed Rule deal with Evaluation and Management (E/M) Codes. The last big change to E/M codes occurred in January 2010 when CMS removed consult codes from the Medicare Claims Processing Manual.

Practices should consider making comments on the MPFS Proposed Rule as it may impact your practice significantly. The proposed rule is available under the PDF link here. Comments are due by Monday, September 10 at 5:00 pm ET and can be made here.  

Just Reporting MIPS is No Longer “Good Enough”

The Centers for Medicare & Medicaid Services (CMS) recently reported that 91 percent of eligible clinicians participated in the first year of MIPS reporting, up from their goal of 90 percent1. What does that mean? That nine percent of the total of clinicians who were eligible to report did nothing–not even the minimal 90-day of data reporting.

In Office Dispensing – Without the Administrative Burden

As the healthcare reimbursement system evolves, oncology practices need increased control of their patients’ health–from adherence to symptom management–avoiding unnecessary hospitalizations and ED visits. The capability to improve continuity of care and increase patient satisfaction will only help to maximize the patient’s experience.

Understanding the QCDR

Qualified Clinical Data Registries (QCDR) were established so that providers could create and choose quality measures that would be more aligned to their specialty. To be used for Merit-based Incentive Payment System (MIPS) reporting under the Quality Payment Program, the Centers for Medicare & Medicaid Services (CMS) must approve each QCDR quality measure not currently listed under the MIPS program.

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