CMS (Center for Medicare & Medicaid Services) recently announced the performance score for eligible clinicians of QPP MIPS 2019 on its official website.
Eligible physicians can review their MIPS 2019 score via a secure portal allotted to them.
This performance score depicts the percentage by which clinicians will be receiving positive, negative, or neutral payment adjustments. However, payment adjustments will be furnished in the year 2021.
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 as due to the pandemic situation going on, CMS enforced a policy to not penalized 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 most important incentive payment models. It accounts for quality healthcare services, which CMS recognizes and rewards for.
The performance review period allows seeing if your data is being reviewed properly or not.
Most of the time, physicians, who submit MIPS data through MIPS Qualified Registry have an idea of their final score. Because their expert resources already have a roadmap to report quality measures to get a certain percentage of the score.
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 for 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)
- Being not 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 offered flexibilities to ease out the administrative load. The option for applying for “the Extreme and Uncontrollable Conditions” is available until December 31, 2020.
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.