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CMS Correcting Errors in 2017 MIPS Final Score Calculations

Eligible clinicians have until October 15 to review their 2017 MIPS performance year feedback and request that CMS resolve scoring errors.

CMS will correct any errors in the MIPS final score calculations of eligible clinicians.

Source: Thinkstock

By Kate Monica

- CMS has extended its targeted review process to October 15 to allow eligible clinicians, groups, and those participating in certain alternative payment models (APMs) to closely look over their 2017 Merit-Based Incentive Payment System (MIPS) final score and identify any calculation errors.

Over 90 percent of eligible clinicians participated in MIPS during the first year of the Quality Payment Program (QPP). Program participants have had the opportunity to access and review MIPS performance feedback over the last few weeks through the CMS QPP website, which offers clinicians an overview of their MIPS final score, performance category details, and 2019 MIPS payment adjustment.

Clinicians or groups who believe there may be an error in their 2019 MIPS payment adjustment calculation can request that CMS launch a targeted review.

“The requests that we received through targeted review caused us to take a closer look at a few prevailing concerns,” stated CMS.

Some concerns clinicians have raised pertain to the application of the 2017 Advancing Care Information (ACI) and Extreme and Uncontrollable Circumstances hardship exceptions, the awarding of Improvement Activity credit for participating in an improvement activities burden reduction study, and the addition of the All-Cause Readmission (ACR) measure to the MIPS final score.

“Based on these requests, we reviewed the concerns, identified a few errors in the scoring logic, and implemented solutions,” stated CMS. “The targeted review process worked exactly as intended, as the incoming requests quickly alerted us to these issues and allowed us to take immediate action.”

CMS has changed the MIPS final scores and 2019 payment adjustments for clinicians who were affected by these issues.

“Additionally, to ensure that we maintain the budget neutrality that is required by law under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), some clinicians will see slight changes in their payment adjustment as a result of the reapplication of budget neutrality,” clarified CMS.

CMS made and published these revisions to clinicians’ 2019 MIPS payment adjustments on September 13. The federal agency encouraged clinicians who may have had their MIPS scores changed to review their performance feedback for any remaining errors.

Clinicians can launch a targeted review process to address any potential errors until October 15.

“From the onset of the Quality Payment Program, our goals have included creating a program that is fully transparent and provides accurate information,” stated CMS. “We believe that the above steps are essential to achieving that goal for the first performance year (2017), also referred to as the “transition” year.”

CMS stated its intention to continue working closely with the clinician community to further improve QPP implementation.

The federal agency is also currently accepting stakeholder feedback on a proposed rule intended to reduce administrative burden on providers by removing unnecessary compliance requirements from Medicare’s conditions of participation, conditions for coverage, and other participation requirements.

The proposed rule targeted regulations within the Medicare program that were deemed outdated and burdensome in accordance with stakeholder feedback submitted in response to CMS requests for information (RFIs).

The proposed changes could save healthcare providers an estimated $1.12 billion per year, according to CMS. Key provisions in the proposed rule aim to reduce the administrative burden associated with supporting patients in need of organ transplants. The provision cuts a duplicative requirement part of transplant programs requiring that providers submit data and other information repeatedly for re-approval by Medicare.

Stakeholders have until November 19, 2018 to submit feedback that will inform the final rule.



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