Merit-Based Incentive Payment System (MIPS): January 2019

7.23.2018

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On July 12, 2018, CMS released a notice of proposed rulemaking (NPRM) detailing proposed changes to the QPP, including the expansion of eligible clinician types to include physical therapists, occupational therapists, clinical social workers, and clinical psychologists.

The QPP was established by Congress in the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. In addition to permanently eliminating the sustainable growth rate, it also sunset the previous reporting programs (Physician Quality Reporting System, the Value-Based Payment Modifier, and the Electronic Health Record Meaningful Use program for Medicare providers) and replaced it with the QPP. The QPP contains two tracks clinicians can choose to participate: the Merit-Based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs). The changes discussed here are with the MIPS program. Initially, the clinician types that were eligible for the first two years of participation (2017 and 2018) included physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists.

For the 2019 performance year, CMS is proposing to add physical therapists, occupational therapists, clinical social workers, and clinical psychologists to the definition of “eligible clinician.” Public comments on the proposed rules are due no later than September 10, 2018. Clinicians or groups who are eligible to participate in MIPS are scored based on their performance in four categories: quality, cost, improvement activities, and promoting interoperability. There are situations in which certain clinicians or groups can be “exempt” from certain parts of the program (e.g., promoting interoperability), and there is a broader exemption from the entire MIPS program if a clinician or a group meets certain criteria.

Also, the CMS Regional Offices have scheduled a webinar specifically targeting physical therapists, occupational therapists, clinical social workers, and clinical psychologists for Tuesday, July 31, 2018, from 1:00 – 2:30 PM EDT. We would ask that you share the following registration link with your members so they can sign up for this important information session: https://www.eventbrite.com/e/cms-quality-payment-program-year-3-proposed-rule-webinar-for-new-partners-tickets-48201918235 

Here are links to information related to the proposed rule:

For a fact sheet on the CY 2019 Physician Fee Schedule proposed rule, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2018-Fact-sheets-items/2018-07-12-2.html 

To view the CY 2019 Physician Fee Schedule proposed rule, please visit: https://www.federalregister.gov/public-inspection/ For a fact sheet on the CY 2019 Quality Payment Program proposed rule, please visit: https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2019-QPP-proposed-rule-fact-sheet.pdf 

 


7/18/2018
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