The 2018 Quality Payment Program Final Rule

Employee performance will now affect Medicare Part B in 2018 with Quality Payment Program Final Rule released. Announced by Medicare and Medicaid Services (CMS) last November 2017, the Final Rule will take effect now for Canadian employees now that it’s already 2018.

Retirement benefits revision and adjustments

In 2018, the benefit amount for retirees is reduced by 0.6%8 for each month from the initial date of the benefit payment and up to the 65th birthday, as the retirement benefits begin before 65. If a pensioner entitled to maximum benefit decides to retire at 60, he or she will have a 36% reduction on the benefit amount.

A 0.7% increase entails benefits paid after 65. For each month following the 65th birthday, the increase goes up to 42% for a five years deferment period. Delaying the benefit until 70 also increases the amount of the benefit.

The benefit amount that shall be paid for the entire retirement period is determined accordingly by the said adjustments. These adjustments also affect the time of claiming of the benefits because evading the reduction is possible if requested at 65 instead of 60. However, one can lose out on generating the income during the five years.

The key points of the Final Rule:

1. 10% of your MIPS score in 2018 will count for cost category.

The proposed rule teetered over 0% count for employee’s score in 2018, but eventually, it was finalized into 10%. The cost measures for Medicare Spending Per Beneficiary and Total Per Capita Cost shall be used. Using administrative claims, these measures shall be calculated by CMS.

2. An increase of the 3 Composite Performance points to 15 in 2018

The threshold for evading negative payment adjustment is now 15 Composite Performance Score—in 2018, submitting data for one measure will no longer enable you to avoid the penalty.

3. 12 months of reporting is required for the Quality category

From the minimum of 90 days of data reporting, the Quality category has increased the requirement up to 12 months.

4. Bonus points are now available for the improving Quality category every year, and the care and provision for complex patients.

Both the Hierarchical Condition Categories (HCCs) and the number of dually eligible patients treated is the basis for patient complexity. For any clinician or group in a small practice with 15 or fewer clinicians, 5 points will be automatically be placed.

5. 2014 or 2015 Certified EHR Technology (CEHRT) are both valid for 2018 MIPS reporting.

However, if you only use the 2015 edition CEHRT for the entire year, there is a 10% bonus available in the Advancing Care Information.

The Québec Pension Plan

Employment earnings under your name since the beginning of the Plan in 1996, is the basis of calculation for your retirement pension. The amount can vary in accordance to the age you began receiving pension.

A retirement pension requires sufficient contributions to the Quebec Pension Plan.

People at the age of 60 can begin receiving pension plans. However, the amount of payment will lower, as the normal retirement age is 65.

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