MIPS Eligible Clinicians and Groups May Request Targeted Review of 2017 MIPS Score

On Friday, June 29, 2018, the Centers for Medicare & Medicaid Services (CMS) released group and individual scores to Eligible Clinicians (EC) for the 2017 Merit-based Incentive Payment System (MIPS). The scores that ECs received will impact their Medicare Part B payments on allowed charges in 2019.

ECs and practices may access their 2017 performance feedback and final score by logging onto their Enterprise Identify Management (EIDM) account via the Quality Payment Program (QP) webpage.

ECs who received 3 or more points out of a possible 100 points avoided a penalty. Those scoring above 3 points are expected to receive bonus payments of up to 4% (on a sliding scale from 0% to 4%) of their allowed charges in 2019. ECs or their practices who receive 0 points will receive a -4% payment adjustment on their allowed charges next year.

MIPS ECs and groups who believe an error has been made in their score may request a targeted review. The deadline to submit for a targeted review is September 30 and CMS may request practices submit additional documentation to support their appeal. CMS has released several fact sheets and a user guide describing the appeal process.

•             Targeted review fact sheet
•             Targeted review user guide
•             Performance feedback fact sheet
•             Payment adjustment fact sheet

For information on the 2017 MIPS categories, please visit the ASA MACRA website and click on “2017 performance year.” Please contact the Department of Quality and Regulatory Affairs (QRA) at [email protected] for further questions.