This Week – January 27, 2018

This Week in Washington, D.C.

  • Start Building Success: ACG’s Practice Management Toolbox
  • ACG Guidance: Practical Tips for Reporting MIPS Data
  • ACG Updates 2018 Medicare Reimbursement Data for GI Services
  • Updated MACRA Information for 2018: ACG’s Guidance Tailored for GI Clinicians

Gastroenterologists in private practice find themselves working in a time of unprecedented transformation. Pressures are high as they make important management decisions that profoundly affect their business future, their private lives, and their ability to provide care to patients.

The ACG Practice Management Committee has a mission to bring practicing colleagues together to explore solutions to overcome management challenges, to improve operations, enhance productivity, and support physician leadership. It was in this spirit that the Practice Management Toolbox was created

Learn from practicing colleagues through articles on topics important to you. Articles include a topic overview, suggestions, examples, and a list of resources or references.  Explore recent articles:

  • Alternative Payment Models (APMs)
  • Merit-Based Incentive Payment Systems (MIPS)
  • Medicare Compliance & Preparation for RAC Audits
  • Developing an Infection Control Plan
  • Quality Improvement Projects in Your Practice
  • Professional Society Opportunities & Involvement


From ACG Legislative and Public Policy Council Chair, Whitfield L. Knapple, MD, FACG

ACG Guidance: Practical Tips for Reporting MIPS Data

As ACG has previously reported, CMS has opened the “Quality Payment Program” website to submit your 2017 MIPS reporting data.  ACG members can click here to begin the process.  The 2017 submission period runs from January 2, 2018 to March 31, 2018.  Group practices who are using the CMS Web Interface have a different submission period: January 22, 2018 to March 16, 2018.

Here are some practical tips for GI practices and ACG members:

Your first step: Find out your status (you may not need to report data)

Determine whether or not you have to worry about MACRA.  Click here and enter your 10-digit National Provider Identifier (NPI) number.  This will tell you whether you meet the thresholds in order to be required to participate in MACRA.  Who has to participate in MACRA for the 2017 reporting year?

  1. If you are a: physician, physician assistant, nurse practitioner, clinical nurse specialist, or CRNA; and
  2. If you bill more than $30,000 to Medicare, and provide care to more than 100 Medicare patients per year.

Your second step: If you meet the eligibility requirements and want to submit your data

You need your Enterprise Identity Management (EIDM) account to log on.  This is the account that you or your practice managers used to access your practice’s quality and resource use report (QRUR), or if your practice previously participated in the physician quality reporting system (PQRS).

Forgot your credentials? Go to the CMS Enterprise Portal to reset your user ID or password.

Don’t have a user account yet? Visit the CMS Enterprise Portal to create one, or call 1-866-288-8292.

From there, the website will send you a verification code to your cell phone or email on file.

Once you are in the system, you will see your personalized MIPS “Dashboard” where you should find each tax identification number (TIN) associated with your National Provider Identifier (NPI) number.

You will need to select whether you are reporting as a “group practice” or as an “individual.”

You will be able to select which MIPS performance category you plan on submitting data for at this time: Quality, Advancing Care Information (aka the new Meaningful Use), or Improvement Activities.

  • You have the option of uploading a file of your reporting data (if you are downloading measures from an EHR, for example).
  • For each performance category, you will select the time period for which you will be reporting data (for example: 90 continuous days).
  • For the required attestations (“yes” or “no” answers), you will have to answer these first before the system will allow you to answer the other questions, as well as submit other data.

Please Read: Some Important Things to Note (click here to check out the full blog post.)


From ACG Practice Management Committee Chair, Louis J. Wilson, MD, FACG

ACG Updates 2018 Medicare Reimbursement Data for GI Services

In November, ACG and the GI societies provided the summaries of the final rules outlining the 2018 Medicare professional and facility fees, among other policy changes.  In CY 2018, ACG members will receive an annual fee schedule update of .41%, absent anything you may have done during the CY 2016 reporting year.  Under MACRA, providers receive an annual update of .5% through December 2019.  However, CMS is also obligated to implement budgetary and other policy changes.  Thus, in 2018, the Medicare fee-for-service 2018 update is .41% as opposed to .5%. 

What are the national average Medicare professional fees and relative value units (RVUs) for many GI services? 

ACG is here to help.  ACG has updated its 2018 Medicare reimbursement professional fees chart for many GI services.  This chart also provides the RVUs for each service, as well as a comparison from 2017. 

CMS also made changes to GI anesthesia services beginning 2018.  ACG is here to help here as well.  Check out ACG’s Guidance on GI Moderate Sedation and GI Anesthesia Changes- What do you need to know?


Updated MACRA Information for 2018:
ACG’s Guidance Tailored for GI Clinicians

ACG members are encouraged to check out ACG’s updated “Making $ense of MACRA” guidance.  Like last year, ACG hopes to keep it simple, keep you well informed, and keep it tailored to clinical GI.  These guidance materials walk you through the 2018 reporting requirements, the various acronyms, the changes to MIPS, as well as the revised requirements for APM reimbursement models. ACG also provides practical examples of how CMS calculates your MIPS’ score, all structured and formatted for busy GI practices and clinicians.

Check out the 2018 Making $ense of MACRA here.

Also, make sure you fulfill your 2017 reporting requirements. Click here to learn more.