As mentioned in a previous blog, the Merit-based Incentive Payment System (MIPS), one of two possible MACRA tracks, involves practices reporting quality data over a set period of time in order to receive reimbursement adjustments in future years. As of right now, the only options are to enroll either as a single provider or as a group of providers under a single tax identification number (TIN), meaning that small practices with only a single provider may miss out on some of the advantages of reporting as a group.
Thankfully, a new way to enroll is just around the corner. Healthcare professionals now have the rest of the calendar year to form virtual groups for the 2018 reporting season. These groups, which can be formed by single providers and practices of ten providers or fewer, can even include providers who don’t qualify for MIPS on their own as long as at least one of the group members does.
There are, however, several rules. Providers can not be members of multiple virtual groups, and they cannot change groups at any point during a performance period. Additionally, the Centers for Medicare and Medicaid Services (CMS) are still working to outline some of the official rules, such as whether or not each provider needs a unique MIPS identifier or how various virtual sizes of virtual groups should be classified. For more information on how this new category works, practices should contact their local technical assistance representatives or the QPP Service Center.
If you are a coder or a biller and your practice is eligible to join one of these virtual groups, you may see some changes in the coming years. Be sure to keep track of all pertinent documentation so that when it comes time to submit MIPS quality data, you will already have the necessary information on hand.