CMS to Inform Practices of MIPS Status

Added on Mar 16, 2017

CMS to Inform Practices of MIPS Status
Industry Edge March 2017

In early April, the Centers for Medicare & Medicaid Services (CMS) will notify practices with less than $30,000 in Medicare payments or that serve fewer than 100 Medicare patients if they are exempt from participation in the Merit-based Incentive Payment System (MIPS) track of the Quality Payment Program, according to Dr. Kate Goodrich, director of the CMS Center for Clinical Standards and Quality.

The Quality Payment Program rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and MIPS for eligible clinicians or groups under the physician fee schedule.

MIPS eligibility status will be key to future planning for 2017, which is the first year of the program, and the level of participation will dictate Medicare bonus payments in 2019. For the first year, practices will have three reporting options.

  • Submit a minimum amount of 2017 data to Medicare (e.g., one quality measure or one improvement activity for any point in 2017) and face no penalties.
  • Submit 90 days of 2017 data to Medicare and be eligible for a neutral or positive payment adjustment.
  • Submit a full year of 2017 data to Medicare and be eligible for the full bonus that is to be determined.

MIPS-eligible practices that do not submit any 2017 data will receive a 4% reduction in Medicare fee schedule payments in 2019.

“We have to expect that we will have some folks who do the minimum” in 2017, Dr. Goodrich said during a session at the HIMSS17 meeting in Orlando, Fla., in late February. “They are just not ready to go beyond that. But even for folks who haven’t participated previously [in reporting programs], we are hearing they want to at least try to do more than just the bare minimum because they want to get ready for future years of the program.”