Medicare Compliance & Reimbursement

Question: We submitted our 2019 Merit-Based Incentive Payment System (MIPS) performance data months ago. When will we hear back on our attestations and will we receive feedback and any payment adjustments for the 2021 payment year like we have in previous performance years?

Florida Subscriber

Answer: According to Quality Payment Program (QPP) guidance, the Centers for Medicare & Medicaid Services (CMS) will provide MIPS-eligible clinicians with their 2019 performance feedback and payment adjustments sometime in July.

Reminder: It’s important to remember that the 2019 performance year submission window just closed on April 30, 2020. Plus, CMS has offered MIPS-eligible clinicians much COVID-19-related relief with deadline extensions, an automatic extreme and uncontrollable circumstances (E&UC) policy on submissions, and other reduced requirements (see Medicare Compliance & Reimbursement, Vol. 46, No. 5).

Important: CMS has not updated its targeted review guidelines for the 2019 performance year yet. However, MIPS-eligible clinicians should expect their data to be assessed and ready for review in their MIPS portals. After assessing feedback and adjustments, providers will have the opportunity to request a targeted review, which is an appeal process to contest any irregularities or mistakes found in the assessments.

Deadline: Once your 2019 feedback and adjustments have been released, you have 60 days before your individual, time-specific targeted review window closes, QPP online guidance suggests.

MIPS-eligible clinicians can expect their 2019 performance year/2021 payment year adjustments to go live on Jan. 1, 2021.

Check the status of your MIPS submissions and update your data at https://qpp.cms.gov/login.