August 05, 2021
Update: CMS Releases 2020 MIPS Performance Scores, Instructions on Appealing
The Centers for Medicare & Medicare Services (CMS) will be updating the Merit-based Incentive Payment System (MIPS) performance feedback and final scores for some clinicians for performance year 2020 and the associated MIPS payment adjustment information for payment year 2022. This updated announcement is to ensure CMS’s transparency by alerting clinicians as soon as possible when issues are discovered.
ECs and groups can view their current MIPS performance feedback, final score, and 2022 payment adjustment. However, CMS is currently reviewing the initial release of scores for any errors and MIPS final scores and payment adjustments may change. The scores can be accessed on the Quality Payment Program website or visiting qpp.cms.gov/login. Once on these websites, ECs and groups should use their HCQIS Access Roles and Profile (HARP) system credentials. ECs and groups that do not have a HARP account should refer to the Register for a HARP Account and Connect to an Organization documents in the QPP Access User Guide.
MIPS ECs and groups, including APM participants, may request that CMS review the calculation of their MIPS payment adjustment factor(s) through a process called targeted review. If an EC or group believes an error has been made in the calculation of their MIPS payment adjustment factor(s), they may request a targeted review. The deadline has been extended to request a targeted review and will be announced at a later date. As a reminder, some examples of previous targeted review circumstances include the following:
- Data was submitted under the wrong Taxpayer Identification Number (TIN) or National Provider Identifier (NPI);
- Eligibility and special status issues (e.g., the EC or group fell below the low-volume threshold and shouldn’t receive a payment adjustment);
- Performance categories weren’t automatically reweighted even though the EC or group qualified for reweighting due to extreme and uncontrollable circumstances.
ECs and groups can request a targeted review by going to the Quality Payment Program website.
CMS generally requires documentation to support a targeted review request, which varies by circumstance. Once submitted, the EC or group will be contacted by a representative with information about any specific documentation required. If the targeted review request is approved and results in a scoring change, CMS will update your final score and/or associated payment adjustment (if applicable), as soon as technically feasible. Targeted review decisions are final and not eligible for further review.
For more information about how to request a targeted review, please refer to the 2020 Targeted Review User Guide. For more information on payment adjustments please refer to the 2022 MIPS Payment Year Payment Adjustment User Guide.