AE July/August 2018 Vol 27 No 4 - 24

RUNNING THE PRACTICE // WASHINGTON
XXXXXXX WATCH

2018 MIPS MID-YEAR CHECK-UP:
IS YOUR PRACTICE ON THE RIGHT PATH TO SUCCEED?
Allison Madson

A

s we come to the midpoint in the 2018 MIPS
reporting year, it's a good
opportunity to make
sure your practice is on
the right track to avoid
any surprises with your
2020 reimbursement. Following
successful legislative and regulatory
advocacy by ASCRS*ASOA and
the medical community, 2018 is
another transition year-which
allows participants to submit minimal data to avoid the penalty-and
coupled with key policy and statute
changes, practices have several options to consider. We've compiled
some key tips for ophthalmology
practices as they continue in this
second year of MIPS.
Small groups have extra flexibility:
Perhaps the most important element for ophthalmology practices
to consider in 2018 is their group
size. CMS has expanded its scoring
accommodations for practices

24

AE // July/Aug 18

of 15 or fewer Medicare-eligible
professionals (MD/DO, OD,
PA, CRNA). Small groups may
apply for a small practice hardship exemption for the Promoting
Interoperability (formerly Advancing Care Information) category.
CMS will then reassign the 25%
weight of the Promoting Interoperability category to Quality. In
addition, small groups will receive
five bonus points on their MIPS
final score and continue to receive
double weighting in the Improvement Activities category and earn
a minimum of three points for any
quality measure submitted-even
if the data completeness threshold
and benchmarks are not met.
Check your eligibility: To reduce
administrative burden on practices
without a large Medicare Part B
patient population, CMS raised the
low-volume threshold to $90,000
in allowed Part B charges or 200
patients. Most ophthalmologists

will not fall below that threshold,
but some may find themselves excluded if they see a high percentage
of Medicare Advantage patients.
Visit qpp.cms.gov to enter physicians' NPIs for an instant determination on whether they are eligible
for MIPS.
Multiple paths to avoid a penalty:
As a result of ASCRS*ASOA advocacy, CMS continued its transition
flexibility by setting the MIPS
threshold at 15 points, up from 3
points in 2017. Any physician or
group scoring at least 15 points
in 2018 will not be subject to a
penalty in 2020. If you just want
to avoid the penalty, take a few
minutes to consider the best route
to reach 15 points. Some options
include full participation in the
Improvement Activities category or
just submitting the base measures
in the Promoting Interoperability
category and one quality measure.
The scoring considerations for


http://qpp.cms.gov

Table of Contents for the Digital Edition of AE July/August 2018 Vol 27 No 4

AE July/August 2018 Vol 27 No 4 - Cover1
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