President Trump's administration announced last week that it will immediately end subsidies that insurance companies and New York State receive to help pay for health care for lower- and middle-income people buying insurance on their own.
New York was one of two states (the other was Minnesota) to implement an optional benefit under the ACA known as the Essential Plan within the NY Health Exchange.
The Essential Plan offers health insurance with maximum premiums of $20 a month to New Yorkers who earn more than the limit allowed by Medicaid, up to 200 percent of the federal poverty level, or $27,720 for a single person. About 665,000 New Yorkers are enrolled in the Essential Plan.
For New Yorkers on the Essential Plan, the cost-sharing reductions go directly to the state to cover costs. This year the payments for the Essential Plan totaled about $925 million. Those payments will end if there were no more cost-sharing reductions.
For a full Q and A on the issue, see recent TimesUnion news article by Claire Hughes highlighting the impact.
As proposed in the 2018 Quality Payment Program proposed rule, solo practitioners and groups can choose to participate in the Merit-based Incentive Payment System (MIPS) as a virtual group for the 2018 performance period.
To form a virtual group for 2018, solo practitioners and groups would need to engage in an election process.
For the 2018 MIPS performance period, the election period for virtual groups to make an election is from October 11, 2017 to December 1, 2017.
What is a Virtual Group?
CMS has proposed a virtual group to be a combination of two or more Taxpayer Identification Numbers (TINs) made up of:
How Do I Form a Virtual Group?
To form a virtual group, CMS has proposed a two-stage virtual group election process:
The election would include:
1. A written formal agreement between each of the virtual group members; and
2. Information about the TIN and NPI associated with the virtual group representative’s contact information.
For more information about joining or forming virtual groups, see theVirtual Groups Toolkit.
Need Help with the Election Process?
Contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292 (TTY: 1-877-715-6222). You can also contact your local support organization for support.
The Centers for Medicare & Medicaid Services (CMS) has recently posted the following new Merit-based Incentive Payment System (MIPS) resources on the CMS website:
The New York State Society of Orthopaedic Surgeons (NYSSOS) received the 2017 State Orthopaedic Society of the Year Award during the National Orthopaedic Leadership Conference (NOLC) in Washington, D.C. Gregory G. Gallant, MD, chair of the Board of Councilors State Orthopaedic Societies Committee presented the award to John M. Olsewski, MD, NYSSOS president.
Babette Grey, executive director of the NYSSOS, was honored as the 2017 Executive Director of the Year. Ms. Grey was recognized for her many accomplishments on behalf of the society, including lobbying for the adoption of a state educational program to train, examine, and license orthopaedic technologists and her efforts to curb a significant cut in workers' compensation reimbursement fees for orthopaedic care.
Dr. Gallant (left) and AAOS President William J. Maloney, MD (right) present Dr. Olsewski with the 2017 State Orthopaedic Society of the Year Award.
Dr. Gallant (left) and AAOS President Dr. Maloney (right) present Babette Grey with the 2017 Executive Director of the Year Award.
What's New in Orthopaedics Saturday, September 23, 2017 On-site at HSS or Live Streaming
Hospital for Special Surgery Richard L. Menschel Education Center 535 East 70th Street, 2nd Floor New York, NY 10021 > REGISTER Please join us at the 2017 New York State Society of Orthopaedic Surgeons Annual Symposium and Meeting on Saturday, September 23, 2017 at Hospital for Special Surgery in New York City. If you prefer to mail in your registration, you may download the brochure here. This year’s theme is “What’s New in Orthopaedic Surgery.” Through a joint providership with Hospital for Special Surgery, the Symposium will deliver brief, high yield presentations in all disciplines of orthopaedics followed by discussions with the audience. Hospital for Special Surgery designates this live activity for a maximum of 7.0 AMA PRA Category 1 Credits™. In addition, participants who elect to purchase and pass the OKU 12 test will receive up to 20 SAE credits. New for 2017: For those unable to join us in person, we are pleased to offer an affordable live streaming option! > Register
Don't put yourself at risk of a 4% penalty under MIPS. To check if you need to submit data to MIPS, enter your 10-digit National Provider Identifier (NPI) number.
If you're exempt from MIPS with the first review, you won't need to do anything else for MIPS this year. If you are included in MIPS, you may be exempt with the second review of eligibility determinations at the end of 2017. Learn more about MIPS eligibility.
To fully participate in MIPS you must report on 90-days of performance in three MIPS categories: Quality (formerly known as PQRS), Advancing Care Information (previously Meaningful Use), and Improvement Activities (new!). Want to maximize your incentive eligibility? To earn the highest MIPS score you must take action before October 2 to plan and attest for a full 90-days of performance for MIPS Improvement Activities.
Check out the MACRA & Delivery Reform Information Center by visiting: www.aaos.org/MACRA-DelieveryReform/
The Performance Measures Unit has finalized the 2017 Orthopaedic Preferred Set of Specialty Measures (OPS) that orthopaedic surgeons can use to comply with the Quality component of the MIPS reporting requirements.
Members of the AAOS Evidence-Based Medicine have created a set of tools to facilitate and encourage the conduct of high-quality research with the goal of establishing a stronger and more comprehensive evidence base for clinical practice guideline (CPG) recommendation and performance measure (PM) development. Drawing on methodology and resources utilized in guideline development, the Research Roadmap seeks to give researchers insight to improve or self-assess their work, regardless of level of
Advocating for the orthopaedic surgeon, patients and musculoskeletal health in New York.
info@nyssos.org 1-518-439-0000 Address: PO Box 38004, Albany, NY 12203
