CMS Creates New Website for Determining MIPS Eligibility Status

WHA and WCHQ-created Physician Compass can help navigate MIPS program

April 20, 2018

The federal Centers for Medicare & Medicaid Services (CMS) has launched a new website for clinicians to determine whether they must report in 2018 under the Merit-Based Incentive Payment System (MIPS) to avoid Medicare payment penalties.

Under MIPS, which was created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), physicians and certain other clinicians must report measures on four performance categories. A clinician’s weighted score on the reported measures results in downward or upward Medicare payment adjustments.

In a given year, a clinician is exempted from participating in MIPS if he or she participates in a qualifying Alternative Payment Model or does not exceed a low-volume threshold. For 2018, the low-volume threshold is Medicare Part B-allowed charges less than or equal to $90,000 or provision of care for 200 or fewer Part B-enrolled Medicare beneficiaries. CMS estimates that nearly 1 million clinicians will be exempt from MIPS reporting in 2018.

Last year, CMS mailed letters to clinicians to inform them of their MIPS eligibility status. With the new website, CMS does not intend to mail letters in 2018.

Understanding MACRA and reporting MIPS measures can often be difficult and confusing. Because of this, WHA, along with the Wisconsin Collaborative for Healthcare Quality, created Physician Compass, an organization designed to help put providers on the path to easy reporting, maximized payment incentives, and quality excellence within the MIPS program. For more information on how Physician Compass can help you, go to www.physiciancompass.org.

For more information about MIPS, contact Andrew Brenton, WHA assistant general counsel, at abrenton@wha.org or 608-274-1820.
 

This story originally appeared in the April 20, 2018 edition of WHA Newsletter