Medicare Compliance & Reimbursement

Industry Note:

Figure Out 2019 Part B Pay from Updated MIPS Performance Data

If you’re curious about what your Medicare pay will amount to in 2019, CMS has updated eligible clinicians’ Merit-Based Incentive Payment System (MIPS) performance information from 2017. The stats are now available on the Quality Payment Program (QPP) website.

The performance feedback includes the MIPS 2017 final scores, which determine 2019 Medicare payments. “A positive, negative, or neutral payment adjustment will be applied to the Medicare paid amount for covered professional services furnished under the Medicare Physician Fee Schedule in 2019,” reminds CMS.

Eligible clinicians (ECs) may log into the Enterprise Identity Management (EIDM) system with the same information used to upload MIPS measures, agency guidance suggests.

Important: Medicare Part B providers who find errors in their 2019 adjusted payments may request a “targeted review,” says CMS. According to a release on the subject, reasons for targeted review might include issues with the measures submitted, low-volume threshold participation problems, accidental exclusion from an Alternative Payment Model (APM), and more.

Deadline: ECs have until September 30, 2018 to ask for a targeted review. “Please note that targeted review decisions are final and not eligible for further review,” cautions CMS.

Resource: Scope out your MIPS 2017 data at https://qpp.cms.gov.

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