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CMS Discovers Errors in Some 2019 MIPS Payment Calculations

CMS Discovers Errors in Some 2019 MIPS Payment Calculations

The Centers for Medicare and Medicaid Services (CMS) has identified errors in the way some 2019 MIPS payment adjustments were calculated.

According to a statement CMS recently sent to providers, issues with the application of the 2017 Advancing Care Information (ACI) and Extreme and Uncontrollable Circumstances hardship exceptions, the awarding of Improvement Activity credit for successful participation in the Improvement Activities (IA) Burden Reduction Study, and the addition of the All-Cause Readmission (ACR) measure to the MIPS final score were identified through the program’s targeted review process. That process allows providers to alert CMS to possible errors in calculations by requesting a review.

“Based on these requests, we reviewed the concerns, identified a few errors in the scoring logic, and implemented solutions,” CMS said in a prepared statement. “The targeted review process worked exactly as intended, as the incoming requests quickly alerted us to these issues and allowed us to take immediate action.”

Addressing these issues resulted in changes to the 2017 MIPS final score and associated 2019 MIPS payment adjustments for many clinicians. These revisions were made to the performance feedback reports on the Quality Payment Program website on September 13, 2018, and CMS encourages providers to sign in as soon as possible to review their performance feedback for any changes.

As well, the deadline to request a targeted review has been extended to October 15, 2018. Providers who believe an error still exists with their 2019 MIPS payment adjustment calculation should request a targeted review as soon as possible by following these steps:

  • Go to the Quality Payment Program website
  • Log in using your Enterprise Identity Management (EIDM) credentials; these are the same EIDM credentials that allowed you to submit your MIPS data. Please refer to the EIDM User Guide for additional details.
  • Follow the instructions for submitting a targeted review.
  • NOTE: When evaluating a targeted review request, CMS will generally require additional documentation. Targeted review decisions are final and not eligible for further review.

For more information, review CMS’s 2017 MIPS Performance Feedback Statement.

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Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

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