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managed care solutions

Medicare MIPS Continues During the Pandemic

By | Blog, healthcare management consulting, managed care solutions

The Centers for Medicare & Medicaid Services (CMS) recently announced that healthcare groups and physicians have until the 5th of October to contest their success score for their 2019 Merit-based Incentive Payment System (MIPS) if they disagree with the amount reported by the Centers for Medicare & Medicaid Services.

CMS recently posted success ratings on the website of the Quality Payment Program (QPP) for physicians and those involved in MIPS, which can be accessed through the portal. The score governs 2021 Medicare payments to doctors and healthcare organizations, who are given an adjustment that’s either positive, negative, or neutral.

MIPS-eligible physicians, associations, and virtual entities — including those who engage in an alternative payment model (APM)—can request a summary by visiting the QPP website.

It is necessary for physicians and groups to review their 2019 performance feedback reports and 2021 payment adjustment scores for accuracy. As a result of the pandemic, CMS introduced a policy aimed at keeping physicians harmless from payment changes if they did not apply 2019 MIPS data.

CMS has also announced the option of opting out of the 2020 MIPS program in full or in part. In order to do so, a request for hardship on the QPP website must be made before December 31, showing the hardship is tied to the pandemic.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.