Despite a global public health crisis, healthcare providers still need to think about Merit-Based incentive Payment System (MIPS) reporting. We know it’s been a tough time, and some providers may experience strong difficulties while collecting the information required for MIPS, as well as fitting into a number of guidelines.
Effective immediately, qualifying providers and groups may apply for certain exceptions in order to meet the program requirements.
Who
can apply for these flexibilities?
Clinicians
who have not been able to collect and record MIPS-required data due to the
pandemic are on the front line to be eligible for the MIPS Extreme and Uncontrollable
Circumstances Exception. Individual Clinicians, Groups, may submit an Extreme
& Uncontrollable Circumstances Application to reweight ANY or ALL MIPS
performance categories.
No, the
reweight due to PHE COVID-19 is not awarded on an automatic basis.
Clinicians
would have to keep written proof of a pandemic-related impact on file (this
information is crucial for data validation or audit by CMS), and the application
needs to be submitted. The
decision to apply should be based on the practice's actual strong need and has
to be carefully reviewed before applying. Failure to do so may result in application
denial or future audits.
The application will be opened up
until December 31, 2020.
CMS
will consider both the circumstances and timing in order to evaluate the
ability of an eligible provider to submit/collect data for each performance
category selected in the application.
For
example, the performance period for an improvement activity is an on-going
90-day period. In contrast, the performance period for Quality performance
category is one calendar year, so an issue lasting for three months may have a
greater impact on the availability of data collection for the Quality
performance category than the provider’s ability to perform and attest to
improvement activities.
Eligible
providers who do not participate in this program will be subject to a negative
payment adjustment of 9% in 2022. This percentage, if measured in dollar
amount, is quite significant!
Make
your practice prosper with WCH Service Bureau, Inc!
https://qpp.cms.gov/mips/exception-applications#extremeCircumstancesException-2020
https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1054/2020%20MIPS%20Exception%20Applications%20Fact%20Sheet.pdf