The Centers for Medicare & Medicaid Services (CMS) has announced that eligible clinicians who participated in MIPS in 2017 can now review their final performance feedback, which includes the final score and payment adjustment information for the 2019 reimbursement year. The information can be viewed by signing into the Quality Payment Program website at https://qpp.cms.gov/
Clinicians will see if they will receive a positive, negative or neutral payment adjustment to the Medicare paid amount under professional services. The clinician (or the practice designee who handles reporting) can ask for a targeted review from CMS if they believe an error has been made. Specific circumstances to request that review include, but are not limited to:
- Errors or data quality issues on the performance measures submitted;
- Eligibility issues (as a small practice, the clinician may have met the low-volume threshold and should not receive a negative adjustment);
- Being wrongly excluded from an APM participation list, and being scored under those standards; or
- Not being automatically reweighted when the clinician should have qualified under the extreme and uncontrollable circumstances policy.
If you believe you or an eligible clinician within your practice may request a review by logging into the Quality Payment Program website, using your Enterprise Identity Management (EIDM) credentials. If EIDM credentials are needed, that process must be completed by July 31, 2018, in order for the review to be processed.
Additional documentation will typically be required within 30 days when asking for a targeted review. A guide on how to request the review is located at: https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2017-Targeted-review-user-guide.pdf
Eligible Clinicians (or their designated support staff) have until Sept. 30
, to request the review. Targeted review decision made by CMS will be final.
If you or your practice needs additional expertise in reviewing the performance feedback, and is considering a targeted review, the Quality Reporting Engagement Group is available to assist you. The team of experts, with more than 25 years of combined experience dealing with Meaningful Use, PQRS and MIPS attestations and submissions, are available to answer questions and help you with the process.