MIPS Blog

With another MIPS performance year behind us, it is not too early to start thinking about a reporting strategy to ensure MIPS success for 2019. This year CMS is providing new flexibility to report quality measures through multiple submission methods which can help improve MIPS scores and increase incentive payments. In this article we demonstrate how combining registry and EHR measures will help specific clinicians with their MIPS reporting. The strategy would not only boost their MIPS scores, but it would also increase their Medicare payments by thousands of dollars.

If you have two or more clinicians billing with the same Tax Identification Number (TIN) in your practice, you should consider reporting MIPS as a group to gain some administrative relief and possibly increase your chances for success. According to a recent CMS 2017 Quality Payment Program Experience Report, more practices chose to report as a group during the first year of the program. An estimated 54% of clinicians reported as a group in 2017. There are many reasons why group reporting is the preferred option for clinicians. Let’s take a look at what group reporting means, and why it may benefit your practice.

CMS recently reported that 95% of MIPS eligible clinicians received a positive or neutral payment adjustment for their MIPS performance in 2017. Unfortunately, this means that 5% of MIPS eligible clinicians will be penalized in 2019 for not reporting MIPS last year. And the penalty for not reporting is even higher this year - an automatic 5% deduction of your 2020 Medicare reimbursements. There’s still time to report MIPS for 2018 to protect your Medicare reimbursement. MDinteractive’s 2018 MIPS Reporting Checklist will guide you through the steps to take now to successfully report MIPS.

CMS has updated the Quality Payment Program (QPP) Participation Status Tool for clinicians to check their final 2018 eligibility status for the Merit-based Incentive Payment System (MIPS). Clinicians can enter their individual National Provider Identifier (NPI) here to learn if they are required to report MIPS for 2018. It’s important for them to check their eligibility status now to determine if they must report.  MIPS eligible clinicians who do not report MIPS this year will receive an automatic negative 5% penalty on their Medicare Part B payments in 2020.

The wait is over - the Centers for Medicare and Medicaid Services (CMS) has finally released the 2019 Quality Payment Program Final Rule  which takes effect on January 1, 2019. There are several changes to MIPS for the 2019 performance year. While providers are still working to complete their 2018 reporting requirements, it’s a good idea to become familiar with some of the changes ahead and understand how you might be impacted.

As we head into the final stretch of Year 2 of the Merit-Based Incentive Payment System (MIPS), clinicians can finally see the finish line approaching for the 2018 performance year. This year MIPS is made up of 4 components: Quality, Promoting Interoperability (formerly ACI), Improvement Activities and Cost. The Quality category accounts for the most at 50% of your total MIPS score. While many clinicians have already collected data throughout the year, it’s not too late to develop a strategy to successfully report Quality and potentially maximize your Medicare reimbursements in 2020.

CMS recently announced it made some changes to the 2017 MIPS performance feedback and is extending the deadline to request a targeted review until October 15, 2018, at 8:00pm (EST). Clinicians and groups are being encouraged to log into their CMS Enterprise Identity Management (EIDM) accounts on the Quality Payment Program (QPP) website to review their final MIPS scores and payment adjustment information for the 2017 performance year.

The minimum reporting requirements and penalties for not reporting under the Medicare Merit-based Incentive Payment System (MIPS) continue to steadily increase each year. Last year, MIPS eligible clinicians and groups could report just 1 patient to earn 3 MIPS points and avoid a 4% penalty in 2019. For 2018, providers must earn at least 15 MIPS points to prevent a 5% cut to their Medicare payments in 2020.

Fortunately, 15 points is still a low threshold and providers have a few different options to meet it.

Before you begin your 2018 MIPS reporting, the first step you should take is to determine if you are required to report this year by checking your participation status on the CMS website. The Quality Payment Program (QPP) Participation Status tool allows clinicians to view their status for each performance year for both the Merit-based Incentive Payment Program (MIPS) and the Alternative Payment Model (APM). Keep in mind if you are not exempt from MIPS participation in 2018, failing to report will result in a 5% penalty on your Medicare Part B payments in 2020.

CMS has opened the Quality Payment Program (QPP) Exception Application process for the 2018 MIPS performance year. MIPS eligible clinicians and groups may submit a hardship exception application for the Promoting Interoperability (formerly ACI) performance category or for the MIPS Program Extreme and Uncontrollable Circumstances. Applications may be submitted to CMS between August 6th, 2018, and December 31st, 2018.