The Radiation Oncology (RO) Model is a new payment approach developed by the Center for Medicare and Medicaid Innovation (the “Innovation Center”) that applies to providers and suppliers of radiation therapy (RT) services. The model will test whether making prospective episode payments for RT episodes of care preserves or improves the quality of care delivered to Medicare beneficiaries while reducing Medicare spending. Clinicians chosen to participate in the mandatory model will be required to annually report Quality measures. While implementation of the model has been delayed to January 1, 2023, providers should become familiar with its potential impact on their practices and learn how MDinteractive can assist them with their Quality data reporting.

CMS has updated the Quality Payment Program (QPP) Participation Status Tool for the 2021 performance year. Clinicians can now check their final 2021 eligibility status for the Merit-based Incentive Payment Program (MIPS) by entering their individual National Provider Identifier (NPI) into the tool or checking their MDinteractive account dashboard. Clinicians can also check their eligibility in an Advanced Alternative Payment Model (APM) and their initial 2022 MIPS eligibility status. It's important to review the participation tool in case there have been any changes in a clinician’s MIPS eligibility.

On November 2, 2021, the Centers for Medicare and Medicaid Services (CMS) issued the Final Rule for the 2022 Medicare Physician Fee Schedule (PFS) which includes several changes to the Quality Payment Program (QPP). The Rule makes significant revisions to the existing MIPS program and outlines a timeframe for transitioning to the new MIPS Value Pathways (MVPs). Here are the key takeaways that will have a major impact on the future of clinician reporting.  

The Centers for Medicare and Medicaid Services (CMS) recently announced it has reopened its reweighting request period for the 2020 MIPS performance year due to the ongoing impact of the COVID-19 pandemic. Clinicians, groups, virtual groups, and Alternative Payment Model (APM) Entities may request MIPS performance category reweighting for 2020 under the Extreme and Uncontrollable Circumstances (EUC) policy now through November 29, 2021, at 8 p.m. ET.  All clinicians should carefully review their final individual and group-level MIPS scores and payment adjustment information as some clinicians are receiving a penalty if their practice coded Medicare Part B claims in 2020.

We understand that keeping track of important dates for MIPS reporting can be a challenge, so we have prepared two lists of key dates to mark on your calendars for your 2021 and 2022 MIPS reporting.  Knowing what to do, and when, throughout the calendar year can save you a lot of headaches when it’s time to report and help you avoid paying any MIPS penalties.

Technology has transformed how consumers perform a variety of daily activities and transactions. With a computer or smartphone, they can buy tickets and book travel, access their bank accounts, use GPS map assistance and so much more. Unfortunately, they don’t have the same flexibility when it comes to healthcare. This is changing, however, with the development of a new standard for exchanging electronic healthcare information called the Fast Healthcare Interoperability Resource, or FHIR (pronounced “fire”).  

The MIPS Promoting Interoperability (PI) category, which replaced the Meaningful Use program, establishes requirements that promote the electronic exchange of information using certified electronic health record technology (CEHRT). MIPS eligible clinicians and groups are scored on their performance on several PI measures. Making sense of all of the requirements can be challenging, so let’s examine how to report the PI category and the potential impact on the MIPS final score.

2020 MIPS performance feedback reports, which include MIPS final scores and payment adjustment information, are now available. Clinicians and groups should carefully review their reporting results. Any positive or negative payment adjustment will apply to their 2022 Medicare Part B payments for covered professional services. A targeted review can be requested until November 29, 2021, if clinicians believe an error was made in their 2022 MIPS payment adjustment calculation.

A timeframe to gradually implement the new MIPS Value Pathways (MVPs) program was recently released as part of the Final Rule for the 2022 Medicare Physician Fee Schedule (PFS). The Rule will allow clinicians to report MVPs beginning with the 2023 MIPS performance year. This article answers key questions about MVPs and how MIPS reporting is expected to change in the years ahead.  

The MIPS Improvement Activities (IA) performance category measures a clinician or group’s engagement in clinical activities that improve clinical practice, care delivery, and outcomes.  It is one of four categories under the MIPS program. This year clinicians will need to attest to Improvement Activities, in addition to reporting the MIPS Quality and Promoting Interoperability categories, to ensure they reach the new minimum threshold of 60 points to avoid a MIPS penalty. This article provides an overview of the Improvement Activities category, explains how to maximize MIPS points, and offers tips on selecting activities most relevant to a clinician’s practice.