MACRA update: MIPS eligibility and reporting registries
The WSMA continues to support our members and practice staff on their transition to MACRA’s new payment models, primarily via our publications and our dedicated MACRA webpage. If you have questions on the next steps for you and your practice, please contact Bob Perna, director of the WSMA Practice Resource Center at firstname.lastname@example.org or 206.441.9762.
Eligibility for MIPS 2017 performance year
Physicians unsure as to whether they are eligible to participate in MACRA’s new Merit-Based Incentive Payment System should note that CMS is sending letters to practices clarifying clinician eligibility for the MIPS 2017 performance year. These letters are being mailed no later than May 31 (most practices should have received theirs by now).
CMS is sending the letters to the practice identified by its taxpayer identification number and addressed to the representative specified in Medicare’s PECOS database. The letter has three parts:
Attachment A, listing the participation status for each National Provider Identifier for the clinicians associated with the taxpayer identification number, according to the PECOS database.
Attachment B, including important Q&As.
After receiving the letter, we advise practice leadership to review Attachment A and advise the clinicians assigned to your TIN whether they are either eligible for MIPS or exempt.
If you believe the information provided in Attachment A is inaccurate, contact the Quality Payment Program either by email at QPP@cms.hhs.gov or by calling 866.288.8292 (Monday-Friday 8 a.m.-8 p.m. ET). TTY users can call 877.715.6222. Locally, you can contact Qualis Health at QPP-SURS@qualishealth.org. CMS has engaged Qualis Health as one of a handful of organizations nationally to assist in these educational efforts.
CMS announces registries for MIPS reporting
CMS has released its 2017 list of approved qualified registries for MIPS-eligible physicians and other clinicians reporting individual or group data.
Reporting data during the 2017 performance year can avoid a negative 4 percent penalty and could earn a small incentive bonus in 2019 payment year.
Here are your options for reporting MIPS data:
Test: If you submit a minimum amount of 2017 data to Medicare (for example, one quality measure or one improvement activity for any point in 2017), you can avoid a downward payment adjustment.
Partial: If you submit 90 days of 2017 data to Medicare, you may earn a neutral or positive payment adjustment and may even earn the maximum adjustment.
Full: If you submit a full year of 2017 data to Medicare, you may earn a positive payment adjustment.
Choose not to participate in the Quality Payment Program: If you don’t send in any 2017 data, then you will receive a negative 4 percent payment adjustment in the 2019 payment year.
The MIPS payment adjustment is based on the data submitted. The best way to get the maximum positive MIPS payment adjustment is to participate for a full year. By participating the full year, you have the most measures to pick from to submit, more reliable data submissions and the ability to get bonus points.
But if you only report 90 days, you could still earn the maximum adjustment—there is nothing built into the program that automatically gives a reporter a lower score for 90-day reporting.
More WSMA MACRA resources
Qualis Health, in collaboration with the WSMA and the Washington State Hospital Association, has introduced a new Quality Payment Program Resource Center. The webpage offers a new interactive toolkit to help you succeed with MACRA’s MIPS pathway.
You’ll also find the MIPS Minutes, an online learning series with brief topic-specific guidance, and the MIPS Tracking Tool, designed to offer clinicians an opportunity to develop a MIPS reporting plan and track results throughout the year. The tool also provides the ability to estimate (or model) how their performance on each MIPS category will eventually translate into a MIPS Final Score for Performance Year 2017.