We can all agree that 2020 has been a unique year for all of us. As things change and shift, many things do still remain the same, including MIPS reporting! We’ve made it to the halfway point of the year, trying to figure out the new normal and what business-as-usual looks like, which may leave you with a fuzzy memory that quality reporting may still need to be completed this year.  

As a qualified MIPS registry, pMD has been keeping an eye on the changes and requirements for reporting in 2020. We continue to offer our customers the tools to submit their 2020 MIPS data to CMS and navigate some of these changes using our robust dashboard and excellent account management.

‍THE ELEPHANT IN THE ROOM

‍Do you have to submit MIPS this year in the midst of a pandemic? Maybe.

Other quality programs have previously released amendments to decrease the amount of data submitted to ease the reporting burden during the first and second quarter of this year. However, for MIPS 2020, eligible providers submitting any of the categories (Quality, Improvement Activities, Promoting Interoperability, and Cost) still have the full year’s worth of reporting on the table and there are no changes to the measure requirements.

The QPP did include a new Improvement Activity to give credit to organizations that participate in COVID-19 clinical trials and offered a complete solution to that performance category:

‍“Clinicians could also pair the new COVID-19 clinical trials activity with the existing Participation in a 60-day or greater effort to support domestic or international humanitarian needs (IA_ERP_2) activity for full credit for the Improvement Activities performance category.”

‍For practices affected by the pandemic, you can apply for an exemption to re-weight Quality, Cost, Improvement Activities, and/or Promoting Interoperability performance categories to 0%. You can find the application and additional information here. CMS will provide the determination of your application via email to the email address you list on your application.

CHANGES TO SCORING

MIPS Year 4 is turning up the heat for additional data and higher scores.  We are met with increased data reporting requirements in two categories and a 50% increase in final score to avoid a negative payment adjustment.

1. Quality measures must meet 70% of data completeness this year.
2. Improvement Activities must apply to 50% or more physicians within a group to attest.
3. The performance threshold has been raised to 45 points to avoid a penalty and 85 points to get an exceptional performance bonus.  

CHANGES TO PAYMENT ADJUSTMENTS

Speaking of payment adjustments, the maximum penalties have been increased again this year.  Clinicians who fail to sufficiently report MIPS are subject to a penalty of up to -9% payment adjustment on Medicare Part B FFS payments. Since the MIPS and MACRA programs have budget neutrality requirements, the rates for positive payment adjustments depend on national submission performance and will be scaled and distributed appropriately. Essentially, the money CMS can pay out to Medicare Part B FFS claim bonuses depends on the number of clinicians who do not submit or perform poorly.

A full list of changes to the Year 4 Final Rule and the most up-to-date information can be found on the QPP website.

We are accepting new practices to report MIPS with us in 2021, feel free to take a look at what we offer for MIPS reporting here or give us a call at 800-587-4989 x2. We’d love to hear from you!