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CMS identifies and corrects errors in MIPS scoring logic



September 14, 2018
Area(s) of Interest: MACRA Practice Management 

The Centers for Medicare and Medicaid Services (CMS) recently released 2017 Merit-based Incentive Payment System (MIPS) performance scores and payment adjustment information for the 2019 payment year. Physicians have been able to request targeted reviews if they believe an error was made in the calculation of their performance score.

The requests CMS received through targeted review led them to take a closer look at a few prevailing concerns. Those concerns included the application of the 2017 Advancing Care Information and Extreme and Uncontrollable Circumstances hardship exceptions, the awarding of Improvement Activity credit for successful participation in the Improvement Activities Burden Reduction Study, and the addition of the All-Cause Readmission measure to the MIPS final score. Based on these requests, CMS reviewed the concerns, identified a few errors in the scoring logic and implemented system-wide solutions.

The 2019 MIPS payment adjustments have been corrected for clinicians impacted by the identified issues. Additionally, in order to ensure the budget neutrality that is required by law under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), some clinicians not directly impacted by the corrections will see slight changes in their payment adjustment as a result of the reapplication of budget neutrality. 

These revisions were made to the performance feedback on the Quality Payment Program (QPP) website on September 13, 2018.

Physicians are encouraged to sign-in to the QPP website as soon as possible to review their performance feedback. If you believe an error still exists with your 2019 MIPS payment adjustment, you can request a targeted review until October 15, 2018, at 5 p.m. Pacific Time. This deadline has been pushed back two weeks to allow additional time for providers to access and review their performance feedback.

Physicians, physician groups and accountable care organizations (and their authorized representatives) can access their performance feedback by logging into qpp.cms.gov with the same EIDM credentials used to submit and view their data during the submission period.

Physicians who need assistance can contact the QPP Service Center at (866) 288-8292 or QPP@cms.hhs.gov.

CMS has posted the 2017 Performance Feedback User Guide on CMS.gov to help eligible clinicians and groups understand their 2017 MIPS performance feedback.

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