What Every Colorectal Surgeon Should Know About the Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015
Centers for Medicare & Medicaid Services (CMS) released the final rule governing the QPP in October 2016. Provider performance in calendar year (CY) 2017 will determine reimbursement for CY 2019. The brief time allowed for physicians to understand the QPP before its implementation and the significant implications for their practices have caused concern on the part of many surgeons.
Not all physicians are required to participate in the QPP. Physicians who see <100 Medicare patients annually or submit less than $30,000 in Medicare Part B allowable charges are exempt from reporting requirements in 2017. Their Medicare fee schedule will remain flat in CY 2019. CMS estimates that approximately one third of Medicare physicians will be exempted by this low-volume threshold. Of course, in a world where practice expenses and the cost of living increases every year, a flat fee schedule is not a desirable long-term strategy for success.