As a healthcare provider, you have likely been following updates related to the Quality Payment Program (QPP), which was established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
If you’re an eligible provider who participated in the Merit-based Incentive Payment System (MIPS) instead of the Advanced Alternative Payment Models (APMs), it’s almost time for reporting MIPS data now that the first calendar year (CY) of its implementation is complete.
According to the Centers for Medicare and Medicaid Services (CMS) website, “you’re included in the Quality Payment Program in 2017 if you are in an Advanced APM or if you bill Medicare more than $30,000 in Part B allowed charges a year and provide care for more than 100 Medicare patients a year.” To be MIPS eligible, you also have to be a physician, a physician assistant, a nurse practitioner, a clinical nurse specialist, or a certified registered nurse anesthetist.
CMS has announced that the deadlines for reporting MIPS data for the performance period in CY 2017 are as follows:
- March 31 for all other MIPS reporting
Here are 10 other important facts to know about reporting your MIPS data:
- If 2017 is your first year as a Medicare provider, you will not participate in the MIPS track.
- Your practice can choose to report as a group or each MIPS-eligible healthcare provider can report as an individual within the practice.
- You can check your individual participation status through the official CMS QPP website using your National Provider Identifier (NPI) number.
- As a practice, you can switch between group or individual MIPS data reporting, depending on your needs. MIPS data reported will be saved for both individual and group reporting, with data that results in a higher score being used by the CMS for determining the individual provider’s payment adjustment.
- If you are submitting as an individual provider, reporting MIPS data in various categories can be completed through an electronic health record (EHR) or qualified registry. An alternative submission option is to send in MIPS data through the routine Medicare claims process.
- Groups can submit MIPS data through a number of ways, including the CMS Web Interface (only available to groups with 25 or more eligible clinicians), a registry, an EHR, the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey (only available to groups with 2 or more eligible clinicians), or attestation.
- If you don’t report MIPS data for 2017 by the deadlines, then you automatically will have a payment adjustment of negative 4%.
- The first performance-based payment adjustments based on submitted MIPS data will take effect on January 1, 2019.
- You can submit MIPS data as frequently as you want until the deadline. Your score will update with your submissions. An outline of what to report is covered here.
- The 2018 QPP Final Rule, covered more in detail here, introduced a number of changes that will impact reporting MIPS data for year 2 (2018). Some of these included virtual groups as a new option for providers to submit MIPS data and 5 bonus points for “treatment of complex patients (based on a combination of the Hierarchical Condition Categories (HCCs) and the number of dually eligible patients treated).”
For more information about the 2018 QPP Final Rule and how it will impact reporting MIPS data for this calendar year, click here to read an article.