Most allergy practices will be required to participate in the Medicare Access and CHIP Reauthorization Act (MACRA) in 2017. What steps should you take now to get started?

1. Check whether you are required to report under MACRA

Physicians that bill Medicare $30,000 or less OR see 100 or fewer Medicare patients annually are EXEMPT from the program. You are also exempt if this is your first year of Medicare participation, or if you are a qualified participant in an eligible advanced APM. Check the Centers for Medicare & Medicaid Services (CMS) online tool to see whether you must participate in MIPS in 2017. All you need is your National Provider Identifier (NPI) to learn if you’re required to participate.

CMS estimates that about one of three allergists will be excluded due to low Medicare volumes. CMS will evaluate claims data from two separate year-long periods to determine 2017 low-volume eligibility: September 2015 through August 2016, and again from September 2016 through August 2017.

2. Evaluate options for 2017

For the 2017 transition year, CMS created a flexible program with multiple reporting options. There are three MIPS reporting options that will exempt physicians from any risk of penalties in 2019:

  • Report all required measures for at least 90 consecutive days and be eligible for a bonus payment. 

If you choose not to report at all, but are required to do so, you will see a 4% reduction in 2019 Medicare reimbursements.

At minimum, every allergy practice should consider reporting ONE improvement activity or ONE quality measure to avoid a penalty in 2019!

3. Get free help

No need to hire a costly consultant or struggle trying to figure this out yourself! CMS has funded programs to help specialty practices of all sizes succeed under MACRA. They will provide FREE, personalized education and support to practices.

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