American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

MIPS Participation for 2017

The Centers for Medicare & Medicaid Services (CMS) has announced that individual physicians and group practices participating in Medicare Part B will receive a letter from their region’s Medicare Administrative Contractor (MAC) between late April and the end of May that addresses their eligibility for participation in the Merit-Based Incentive Payment System (MIPS) track of Medicare’s new Quality Payment Program (QPP) for the 2017 performance year. You can also enter your national provider identifier (NPI) in the CMS MIPS Lookup Tool to learn whether you should participate in 2017.

CMS MIPS Lookup Tool

Clinicians deemed eligible for MIPS participation must submit at least some 2017 data to avoid a negative 4% adjustment on 2019 Medicare Part B payments. During the first year of the QPP, only minimal MIPS data reporting is needed to avoid a penalty.

According to CMS, each registered Taxpayer Identification Number (TIN) within Medicare’s Provider Enrollment, Chain and Ownership System (PECOS) will receive a mailing at the TIN’s address on file that includes a cover letter, an eligibility letter, and a list of important questions and answers. Physicians should note that Eligible Clinicians (ECs) who practice under multiple TINs will receive separate individual letters and/or be listed on multiple group letters for each unique TIN and practice/office combination. In these instances, ECs may be assigned different eligibility categories for MIPS participation during the 2017 performance year.

MIPS Exemptions

For the 2017 performance year, there are three categorical exemptions from the MIPS track of CMS’ QPP:

  • ECs in their first year of Medicare Part B participation;

  • ECs with less than $30,000 in Medicare Part B allowed charges or less than 100 Medicare patients; or

  • ECs participating in Advanced Alternative Payment Models (APM), subject to certain payment and patient count thresholds.

Physicians and group practices participating in Medicare should take the steps necessary to verify that all of the contact and practice information in PECOS and in any processing systems utilized by the MAC within their geographical region(s) is current and accurate.

The AOA’s Physician Services and Public Policy teams are here to help. For further assistance, please contact us via telephone at (888) 62-MYAOA (888-626-9262) or email us at physicianservices@osteopathic.org.

 
 

 Share This