MACRA and the Quality Payment Program   

11/02/2017 - CMS Releases Final Rule for the Quality Payment Program, Year 2

The most significant change impacting the chiropractic profession is the increase in the low volume threshold (LVT).  For 2017, providers were exempted from participation in MIPS if their Part B allowables were less than or equal to $30,000 or if they had 100 or fewer Medicare beneficiaries as patients.  For 2018, CMS has increased the LVT.  Providers are now exempted from MIPS if their Part B allowables are less than or equal to $90,000 or if they have 200 or fewer Medicare beneficiaries.  This reduces the number of chiropractors who are eligible to participate in MIPS by almost 1000 - for 2018 just under 600 chiropractors will be eligible.

For additional details on what has changed in Year 2 of the Quality Payment Program, please see the following resources:

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), signed into law in April 2015, fundamentally changes how physicians and other clinicians are reimbursed under the Medicare Physician Fee Schedule (PFS). The MACRA law permanently repealed the fatally flawed Medicare Sustainable Growth Rate (SGR) methodology for updates to the PFS, and replaced it with a payment structure that creates incentives for the delivery of value-based, high-quality, efficient patient care versus volume-based care.

MACRA was designed to offer providers two new Medicare payment model pathways. On Oct. 14, 2016, the Centers for Medicare and Medicaid Services (CMS) released a final rule that detailed the regulations for creation and implementation of these new payment system pathways, collectively referred to as the Quality Payment Program (QPP). As of Jan. 1, 2017, doctors of chiropractic are eligible to participate in one of the pathways. Learn more by clicking the links below.

An Introduction to MACRA

Overview of the Merit-Based Incentive Payment System (MIPS)

MIPS Eligibility and Participation

MIPS Performance Categories

MIPS Performance Scoring and Payment Adjustments

Where Do I Begin? 

MACRA and QPP Resources

MACRA Education Videos (available to all)

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