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   RE: Required Programs
 From: Melissa Weakland
 To: Member Forum
 Posted: 11-01-2017 11:53
 Message: Jessica,

I'm jumping in the middle of the discussion back to you.

I think I had the exact same thing- letter that I'm exempt a bit ago (for future I don't need to submit and won't be penalized) but penalty letter of 2% yesterday for past (2016 MU).

Given the numbers I'm not sure worth my time/ staff time to figure out why we'll get the 2% penalty in 2018 as we tried to comply with 2016 MU requirements. The letter states to look on-line at your data before talking to them but doesn't really say where to go to look. It gives a link just to "find out more" about where you might go to get your data.  But it rubs me wrong so I have to decide to track it down or not. How is it in medicine we're told we didn't make the grade but aren't given any information supporting this claim.

They really don't make it easy to say the least.

I've been talking with insurers and some of the institutional groups of late.  They do seem to get how hard as IMPs it is to make this all work. But I sometimes wonder if they get its equally hard for the big groups- they just have a bunch of money to throw at it to make it work.  I imagine there is likely plenty talk but I'm not hearing the conversation that this is a crummy way to be spending health care dollars.


Melissa Weakland MD
Ballard Neighborhood Doctors
Seattle WA
IMP since 2007
Original Message:
Sent: 11-01-2017 10:15
From: Jessica Rongitsch
Subject: Required Programs

I agree I am completely confused. I have about 8 Medicare patients and called CMS over a year ago and they told me I was exempt due to not billing enough/few Medicare patients (although I never received a letter.)  I just received a letter from CMS yesterday that we're being penalized 2% since we didn't fulfill requirements.

When I go to CMS website and look at the pages of instructions full of MIPS/MACRA/APM/PQRS my head spins and it just doesn't feel worth it for 8 patients.  In addition at one point I contacted our EHR ECW to see how to use their program to report and you have to purchase a separate product and then also pay per patient.

Now I'm wondering if there is another component I'm missing for which I am not exempt to warrant the penalty.

Jessica Rongitsch MD, FACP
Capitol Hill Medical
Seattle, WA

Original Message:
Sent: 10-26-2017 14:44
From: Craig Ross
Subject: Required Programs

1.  If you are exempt from MIPS/MACRA, you should have received a letter from CMS stating so.  If you are a new practice, I believe you are automatically exempt this year.  You need to find out.  See below for the .pdf to find help (Page 1).

2.  If you are exempt, you "can" submit MIPS/MACRA data but it won't count.  You won't get incentives or penalties.

3.  Meaningful Use for Medicare has been absorbed into MIPS.

4.  If you are involved in MU for Medicaid, you can continue the program until the last year of eligibility.  I think it's too late to start MU for Medicaid.  The law was an attempt back in 2010 to get providers into EMRs but you had to commit by a certain date.  Double check this.  It was great b/c all I had to do was "attest" the first year and prove 30% of my patients during any 3 month period where Medicaid (easy for a start up if you take Medicaid).  For that, I got an $18,000 check - big $$ for a start up.  Now I get $8000/yr but the work is more and more painful.

Here is where you can go for help:

There are two programs.  The first page lists the CMS contracted/funded corporations that can guide you and educate you on all these quality programs.  The one for Michigan helps me report Medicaid MU.  I've also signed up for MIPS assistance because it was free.  I'm exempt so I can't report MIPS but I'm still using their help to set up my practice to be ready to report if/when I am required to report.

The second page lists Practice Transformation Networks.  These CMS contracted/funded corporations help you to change practice systems to "conform" to what CMS/Medicare wants you to be doing.  Of course, what they want matches the MIPS incentives.  Some of it is stupid and I choose not to do it.  Some of it is helpful.  My PTN has a depression screening and treatment practice improvement program which I'm doing.  It's not very helpful because I've already been screening everyone but it checks the box for ABFM practice improvement requirement.

Total cost for all this help is $200 for the year.  CMS picks up about $2500.  Some of it is REALLY helpful (assistance with SRA and electronic registries for Medicaid MU) and some of it is so-so (PTN).


Craig Ross, M.D.
Family Medicine
South Arbor Family Care
Ann Arbor, MI
M: 734-756-8446
W: 734-707-7075

Original Message:
Sent: 10-26-2017 08:25
From: Laurie Troup
Subject: Required Programs

Good morning Michael,
Thank you for the link. I still don't see any current programs to sign up for.

Sent from my iPad

Original Message------

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