MCMS Physician Fall 2017 - 14

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Legislative Update

2017 Legislative Priorities
The Proposed 2018 Medicare
Physician Fee Schedule

10 Things Physicians Should Know


hysicians and physician practices expecting negative
Value-based Payment Modifier (VBPM) payment
adjustments in 2018 for quality performance in 2016
would see reduced penalties - or, in certain cases, no
VBPM penalties at all - under the proposed 2018 Medicare
Physician Fee Schedule (PFS) released by the Centers for Medicare
and Medicaid Services (CMS) on July 13, 2017.

* Making the Consumer Assessment of Health Plans Survey
(CAHPS) for PQRS Survey optional under the group
reporting option (GPRO) for practices of 100 or more eligible
clinicians. Under previous rules for PQRS in 2016, this
had been a requirement for groups of 100 or more eligible

Here's a look at ten things physicians and practices should
know about the proposed 2018 Medicare PFS:

These changes have the potential to enable physicians and
practices to meet 2016 PQRS reporting requirements, even if they
did not meet the original 2016 requirements for those programs.

1. Revised VBPM Payment Adjustments

3. Payment update

CMS is proposing these changes to reduce previously-finalized

CMS says that proposed 2018 PFS conversion factor is $35.99,
an increase to the 2017 PFS conversion factor of $35.89. This
equates to approximately a 0.31% increase to the PFS.

* Hold all groups and solo practitioners who met 2016
Physician Quality Reporting System (PQRS) reporting
requirements harmless from any negative VBPM payment
adjustments in 2018.
* Reduce penalties for physicians/groups who did NOT meet
PQRS minimum reporting requirements. CMS proposes
reducing the penalty from negative 4 percent to negative 2
percent for groups with 10 or more eligible professionals, and
it also proposes reducing the penalty from negative 2 percent
to negative 1 percent for groups of 2-9 clinicians and solo

4. Patient relationship codes
The Medicare and CHIP Reauthorization Act (MACRA)
required CMS to create patient relationship categories. CMS is
proposing the use of Level II Healthcare Common Procedural
Coding System (HCPCS) codes to indicate these new categories.
These codes could then be reported by clinicians on a voluntary
basis, starting Jan. 1, 2018.

5. Diabetes Prevention Program
2. Revised PQRS quality reporting requirements
for 2016 performance
To align its old quality programs with the new Merit-based
Incentive Payment System (MIPS), CMS is proposing revisions
such as:

CMS plans to implement the Medicare Diabetes Prevention
Program (MDPP) expanded model starting in 2018. Look for
details on this program - including guidance for practices who
wish to offer these services - from the Pennsylvania Medical
Society (PAMED) in the coming weeks.

* Reducing the PQRS reporting requirement of 9 measures
across 3 National Quality Strategy domains to only require
reporting of 6, with no domain or cross-cutting measure

M C M S P H Y S I C I A N 14 F A L L 2 0 1 7

Table of Contents for the Digital Edition of MCMS Physician Fall 2017

MCMS Physician Fall 2017 - 1
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