CMS Extends MIPS Targeted Review Request Deadline to Oct. 15

Scoring Errors Prompt Change

September 26, 2018 12:41 pm News Staff

Family physicians who participated in the Merit-based Incentive Payment System (MIPS) in 2017 likely are aware that MIPS final scores and performance feedback reports have been available on the CMS' Quality Payment Program website since midsummer.

[october 15 calendar concept]

However, some physicians may be surprised to learn that due to scoring errors, CMS has recalculated some scores and extended the targeted review deadline to Oct. 15 at 8 p.m. EDT.

Here's what happened.

When CMS released final scores for the 2017 MIPS performance period in July, the agency also initiated its targeted review period -- a timeframe that gives physicians who think there is an error in their 2019 MIPS payment adjustment factors an opportunity to request a targeted review.

It's important that those MIPS adjustment factors are accurate, given that they will be applied as positive, negative or neutral payment adjustments to physicians' 2019 Medicare Part B payments.

However, some of those first targeted reviews identified a few errors in CMS' scoring process.

"The requests that we received through targeted review caused us to take a closer look at a few prevailing concerns," wrote CMS in a message to physicians.(www.cms.gov) "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."

Those concerns included the

  • application of the 2017 Advancing Care Information (now called Promoting Interoperability) hardship exception and the Uncontrollable Circumstances hardship exception,
  • awarding of the Improvement Activity credit for successful participation in the Improvement Activities Burden Reduction Study, and
  • addition of the All-Cause Readmission measure to the MIPS final score.

"Based on these requests, we reviewed the concerns, identified a few errors in the scoring logic, and implemented solutions," said CMS.

Addressing and correcting those elements resulted in changes to some physicians' 2017 MIPS final scores and in their resulting 2019 MIPS payment adjustments.

In addition, some clinicians could see a slight change in their adjustments based on reapplication of mandated budget neutrality in the distribution of MIPS payment adjustments.

The revisions needed were made to the performance feedback on the Quality Payment Program website(qpp.cms.gov) and have been available to physicians for review since Sept. 13. Physicians who accessed the site before that date -- or who have not yet reviewed their performance feedback -- are encouraged to log in and examine their reports as soon as possible.

Need assistance? Contact the QPP Service Center by phone at 866-288-8292 or email service center staff.

Local, no-cost technical assistance(qpp.cms.gov) also is available to physicians.