CMS recalculates 2017 MIPS scores and payment adjustments

September 17, 2018

CMS recalculates 2017 MIPS scores and payment adjustments

The Centers for Medicare & Medicaid Services (CMS) just announced they revised the 2017 Merit-based Incentive Payment System (MIPS) final scores for physicians impacted by the following issues:

  • Application of the 2017 Advancing Care Information and Extreme and Uncontrollable Circumstances hardship exceptions.
  • Awarding of Improvement Activity credit for successful participation in the Improvement Activities Burden Reduction Study.
  • Incorrect attribution of the All-Cause Readmission measure to certain physicians and group practices’ MIPS final score.

Since CMS is required by law to maintain budget neutrality for MIPS, other physicians will see slight changes in their MIPS payment adjustment. We encourage allergists and groups to sign in to the Quality Payment Program website as soon as possible to review your performance feedback. If you believe an error exists with your 2019 MIPS payment adjustment calculation, you can request a targeted review by Oct. 15 (extended from Oct. 1).

CMS has several resources available on the Quality Payment Program Resource Library to help you understand their performance feedback and the targeted review process. If you are in need of additional assistance, please reach out to the Quality Payment Program Service Center by phone at 1-866-288-8292 or by email.

Promoting Interoperability hardship application now available

If you’re required to participate in MIPS in 2018 as either an individual or a group, you can submit a Quality Payment Program Hardship Application for the Promoting Interoperability (PI) performance category (formerly Advancing Care Information) for any of the following reasons:

  • Small practice (less than 16 providers);
  • Electronic health record (EHR) decertification;
  • Insufficient internet connectivity;
  • Extreme and uncontrollable circumstances, including:
    • A natural disaster in which the EHR was damaged or destroyed
    • A practice or hospital closure
    • Severe financial distress such as bankruptcy
    • Vendor issues
  • Lack of control over the availability of certified EHR technology.

If you’re part of a small practice (less than 16 providers) that must participate in MIPS but you don’t have an EHR, this is the application to submit. If your application is approved, the PI performance category will be reweighted from 25% to 0% of the final score, and the Quality performance category will be increased to 75% from its original 50%. The application deadline is Dec. 31, 2018.

For help with 2018 MIPS reporting, check out the College’s MIPS toolkit, which is geared specifically for allergy and immunology practices.