Diane,
I recently attended a "Medicare changes (Spring 2018)" seminar given by CGS Provider Relations Senior Analyst, Vanessa A. Williams.
This question was brought up as well. Vanessa stated that the advantage plans have the option to follow Medicare, but so far she has not seen any in Ohio. You would have to check with each advantage plan in your area for a definitive answer, unfortunately.
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Kristen Sliwinski, CCA, RCC
StreamlineMD, A PRC Medical Company
Cuyahoga Falls, OH 44221
(330) 564-2645
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Original Message:
Sent: 05-07-2018 11:26
From: Wendy Lomers
Subject: 2016 PQRS Penalty Question
Diane,
That is what we have seen in the past but there has been some discussion and I have seen language in one managed care contract that would allow them to apply the same payment adjustment to the Advantage payments. This could be a good thing for physicians who perform well but -alternatively, a bad thing if they do not.
Short answer- I have only seen it on the direct Medicare patients so far. Wendy
Original Message------
Good Morning,
I want to confirm that if you failed the PQRS for 2016 the penalty only applies for Traditional Medicare and not any MAP plans. I couldn't find any verbiage confirming this and want to make sure we are correct on this as I am not seeing any penalties on Medicare Advantage Plans only our Traditional Medicare.
Thank you in advance.
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Diane Ramirez
Business Office Manager
Radiology and Imaging of South Texas LLP
Corpus Christi TX
361-853-4503
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