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.

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.

Are you a solo practitioner or small practice struggling to understand MIPS requirements? When it comes to MIPS reporting, small practices face unique challenges that can make compliance seem like a daunting task. Choosing not to report could be a costly mistake, though, since the penalty for not reporting in 2018 has increased to 5% of your Medicare Part B reimbursements. Fortunately, CMS has taken several steps to provide relief to small practices so they can successfully participate in MIPS for the 2018 performance year.

Are you wondering how you performed in the 2017 MIPS program?  The wait is finally over. MIPS eligible clinicians and groups can now view their performance feedback for their 2017 MIPS submission on the CMS Quality Payment Program (QPP) website.  The performance feedback will include the clinician's or group’s final score and payment adjustment information.  Any upward, downward or neutral payment adjustment will apply to the provider's or group’s 2019 Medicare Part B payments for covered professional services.

Year 2 of the MIPS program, which runs from January 1, 2018, to December 31, 2018, will directly impact your Medicare Part B reimbursements in 2020. Understanding how CMS determines your final MIPS score will ensure your practice avoids any Medicare cuts, while giving you the opportunity to maximize your practice revenue.

CMS announced it exceeded its year one participation goal for the Quality Payment Program. According to CMS Administrator Seema Verma, 91% of eligible clinicians participated in the Merit-based Incentive Payment System (MIPS) in 2017. Submission rates for Accountable Care Organizations (ACOs) were 98% and rural practices were 94%.

CMS announced it will release MIPS Final Scores and Feedback for the 2017 Performance Year in July. Clinicians can view their preliminary performance feedback now on the Quality Payment Program website. However, the scores can change between now and July based on a few different factors.

Choosing what MIPS measures to report for your practice can be overwhelming, especially when you are reporting on behalf of several providers, across multiple specialties, and in some cases at different practice locations. An important consideration is whether group reporting could reduce the amount of time and resources your practice spends on your data reporting activities, while maximizing your MIPS scoring potential.