QPP MIPS, MIPS 2020 performance, MIPS Qualified Registry, healthcare services, submit MIPS data, healthcare system, MIPS reporting

Flexible Medicare MIPS Reporting Options Available Amidst Corona

In the last quarter of 2020, CMS (Centers for Medicare & Medicaid Services) announced the performance scores for clinicians of QPP MIPS 2019 on its official site.

Clinicians who participated may review their MIPS 2019 scores via a secure portal allotted to them. That along with your participation in MIPS 2020 reporting is going to add up to your revenue. God willing, you deserve every bit of it!

Ordinarily, the performance scores depict the percentage by which clinicians receive positive, negative, or neutral payment adjustments. However, for 2019, payment adjustments will be furnished in the year 2021. Once you have them, you are all set for incentives in 2022.

Review Window for MIPS 2019 Is Closed Now

October 5, 2020, was the last date to check and challenge the MIPS 2019 performance score. During this period, individuals, groups, virtual groups, and even APM (Alternative Payment Model) participants can apply to review their score, if they disagree with it.

There was no special requirement to review data. With the same credentials, you submitted data, you could check the performance score.

It is to be noted that it is the best approach to check feedback. Due to the pandemic, CMS enforced a policy to not penalize any physician, who could not submit data in the previous year.

(If you submitted data through MIPS Qualified Registry, they can review feedback on your behalf.)

Check Points for Performance Review

QPP MIPS is one of the incentive payment models with a goal. It accounts for quality healthcare services, that CMS recognizes and rewards for.

The performance review period allows seeing if your data is being reviewed properly or not.

Mostly, physicians who submit MIPS data through a MIPS Qualified Registry have an idea of their final score. Because registries like ours possess the right resources who follow a set roadmap to report quality measures, and in doing so, they can predict the scores.

Hence, QPP MIPS data submission through a qualified registry takes your stress away. You already become aware of your final score, and even strategize to maximize performance.

You can see the following situations while reviewing the MIPS performance score:

  • Errors or quality data loss in the MIPS submitted performance quality measures.
  • Eligibility and special status issues (Example: low-volume threshold performance).
  • Not being listed in the APM participation, thus, not being reviewed.
  • No performance categories reweighted although you qualify for automatic reweighting under the CMS extreme and uncontrollable circumstances clause.

Relaxations for QPP MIPS 2020 Data Submission

COVID-19 has overburdened the healthcare system beyond its handling capacity. Doctors do not have time to compile necessary data as per the CMS requirements.

In such tough times, CMS offers flexibility to ease out the administrative load. The option for applying for “the Extreme and Uncontrollable Conditions” was available until December 31, 2020. However, the deadline for MIPS 2020 submission still has some time left. If you are among the practices, that are eligible yet non-compliant, P3 may submit on your behalf. It protects you from a 9% penalty while brightening your chances towards 5% MIPS incentives.

Flexible Reporting Options

AMA (American Medical Association) requested CMS to offer flexible QPP MIPS reporting options and other incentive payment models.

Eligible physicians can choose not to be scored against “Cost” and “Quality” measures. In such a case, CMS only analyzes their performance based on “Improvement Activities (IA)” and “Promoting Interoperability (PI)” MIPS performance categories.

What More to Expect?

CMS is working alongside AMA to address issues related to QPP MIPS data submission during the COVID-19 pandemic.

We, stakeholders of the healthcare industry, can expect improvement in the Medicare payments and flexible regulatory guidelines. Let’s see how it goes for MIPS 2020 and the upcoming years.

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