Believe it or not, we’re halfway through the 1st year of the Quality Payment Program (QPP). ASCO, the Centers for Medicare & Medicaid Services (CMS), and other stakeholders have released guidance on successfully complying with QPP, but tailored information addressing a practice’s specific circumstances during this transition period can be harder to find.
ASCO has developed a MACRA decision tree tool to help oncology practices find precise information on their QPP participation status and any applicable Merit-Based Incentive Payment System (MIPS) exceptions, based on practice– or provider-specific information. With answers to a few basic questions, the tool can help determine the participation status of everyone in a practice; identify performance categories from which providers may be exempt or have lessened reporting requirements; and identify differences in reporting requirements for specific individuals depending on whether they choose individual or group reporting.
The decision tree can answer:
- Am I subject to MACRA and QPP?
- Do I participate in a CMS-recognized Advanced Alternative Payment Model (APM)?
- Am I a MIPS-eligible clinician?
- Do I participate in a MIPS APM (a specific type of APM that does not meet the requirements to be an Advanced APM)?
- Do any exemptions or special circumstances apply to me (includes factors such as professional designation, number of Medicare patients seen annually, practice site(s), and the size of the practice)?
- Do these exemptions or special circumstances affect decisions regarding individual vs group reporting?
Access the decision tree at ASCO.org/MACRA.
More on MACRA
For more than 2 years, oncology practices have been preparing for implementation of the Medicare Access and CHIP Reauthorization Act (MACRA), which is completely transforming the way practices are reimbursed for Medicare Part B services. QPP, established by MACRA, launched in January 2017. Visit ASCO in Action at ascoaction.asco.org for breaking cancer policy developments and the latest on MACRA implementation. ■
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