AAOS October 3, 2017
Advocacy Now
Legislation Introduced to Address EHRs, HIT

Orthopaedic Device Forum Meets in Washington, DC

Tomorrow! Webinar on Working with Members of Congress in Their Home District

Free Event!
The Impact of Health Care Delivery Reform on Orthopaedics

AAOS Supports Stark Reform Efforts

Panel Discusses Doctor-Patient-Government Relationship

State Corner – ICYMI: AAOS, State Orthopaedic Societies Successful in Combating Insurer Campaign to Set Payment Rates to Medicare

Resurgens Orthopaedics Lobbies Congress

Apply For, Share New Advocacy Fellows Program for Residents

Political Graphic of the Week

What We’re Reading

Quality Payment Program Updates

New Resident PAC
One Pager

PAC Participation Leader Board by State

Thank You to Our Current Orthopaedic PAC Advisor’s Circle Members!

AAOS Orthopaedic PAC Online and Mobile Donations

Follow Our New Twitter
Account @AAOSAdvocacy

AAOS Website

AAOS Calendar

House of Representatives Legislative Activities

Senate Legislative Activities

Quality Payment Program Updates

Quality Payment Program

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, and the Centers for Medicare & Medicaid Services (CMS) then replaced it with the Quality Payment Program. Remember – the Quality Payment Program has two tracks you can choose: Advanced Alternative Payment Models (APMs) OR the Merit-based Incentive Payment System (MIPS). AAOS has shared the details of QPP and MIPS, which can be found on our website, here: www.aaos.org/MACRA_QualityPaymentProgram/ and here: www.aaos.org/MACRA-DeliveryReform/.

  On June 20, CMS released a proposed rule that would make changes in the second year of the Quality Payment Program, including participation requirements for 2018. AAOS has been working closely with CMS to address many concerns related to the Quality Payment Program, including the need for additional flexibility and simplification, as well as protection for small, solo, and rural practices. In this proposed rule, CMS has taken significant steps to respond to these concerns, and AAOS provided CMS with comments. For any questions or comments related to this proposed rule, please email macra@aaos.org.

CMS has designated 2017 as a transition year for quality reporting under MIPS, allowing providers to take advantage of the “Pick Your Pace” option in MIPS. There are four options during this transition period:

  • No reporting: incurs a -4% payment adjustment
  • Submit something to avoid a penalty: a single quality measure for a single patient qualifies
  • Submit partial year: submit data for a 90-day period
  • Submit a full year: submit data for full year

Those providers who submit partial or full-year data can potentially earn a positive payment adjustment. However, to avoid incurring a penalty, submission of a single measure is required. The American Medical Association (AMA) recently shared an educational tool, entitled “One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting,” which includes a short video offering simple instructions for reporting.

Additionally, CMS recently sent out letters to notify providers whether they had been slated to participate in MIPS. If you have not received a letter from CMS regarding MIPS eligibility, you may use an interactive tool on the CMS Quality Payment Program website to determine if you should participate in 2017. To determine your status, enter your national provider identifier (NPI) into the entry field on the tool which can be found on the Quality Payment Program website at https://qpp.cms.gov/. Information will then be provided on whether you should participate in MIPS this year and where to find resources.

To get the latest information from CMS, visit the Quality Payment Program website. The Quality Payment Program Service Center may be reached at 1-866-288-8292 (TTY 1-877-715- 6222), available Monday through Friday, 8:00 AM-8:00 PM ET or via email at QPP@cms.hhs.gov.