Unsure how or if you will avoid the MACRA penalty?

September 5, 2017

We’re now more than half-way through 2017 and the first year of the MACRA Quality Payment Program. Practices must participate in MIPS or Advanced Alternative Payment Models in 2017 to avoid a 4% penalty in 2019 – unless you meet the current low-volume exemption ($30,000 or less in Medicare payments OR 100 or fewer Medicare patients).

However, 35% of respondents to a recent multi-specialty MACRA preparedness survey said they were not sure whether or how they would participate in MACRA in 2017. Another 10% said they would not participate at all and would accept the 4% penalty.

If you’re one of the 45% of practices that aren’t sure how to participate or don’t plan to participate, it’s not too late to avoid the penalty! With minimal reporting (only one quality measure for one patient OR one improvement activity for 90 days) you can avoid the 2019 penalty.

Disturbingly, only a tiny percentage of survey respondents who claimed to be exempt from MIPS said they were notified by CMS of their exemption. If you believe you’re exempt but haven’t been notified by CMS, check the online CMS MIPS participation lookup tool.

The Advocacy Council will continue to advocate on your behalf with CMS, and the College will provide tools to help you navigate these complicated programs. Check out our MIPS toolkit for resources to help you choose the best path for your practice.

Also, mid-August was the deadline to submit comments on the Trump administration's proposed rule (effective 2018) to ease some of the burdens in the Medicare Access and CHIP Reauthorization Act (MACRA). The Advocacy Council has submitted comments on MACRA at every opportunity along the way, and was recently recognized as a thought leader on this topic by a major medical news organization.

A recent MedPage Today article specifically highlighted the College’s recent comments on the expansion of the low-volume exclusion from the Merit-based Incentive Payment System (MIPS). As a reminder, the College commended the Centers for Medicare & Medicaid Services (CMS) for its proposal to increase the low-volume threshold for exclusion from MIPS. The College also said the proposed $90,000 or 200 patient annual threshold is reasonable and will be very helpful in easing the burden on small practices.