Updated information: The deadline for MIPS targeted review has been extended to Oct. 15 at 8:00 p.m. (ET). Due to CMS calculation errors for Improvement Activities and Advancing Care Information that warranted recalculations, CMS is asking that providers who already logged in to the Quality Payment Program website for their feedback do so again to review their performance feedback.
NextGen Healthcare strongly recommends that every client who participated in Merit-based Incentive Payment System (MIPS) in 2017 log-in to CMS to review their MIPS 2017 final score and performance feedback. Logging in to CMS is the only way to see this information; CMS will not send the information to you!
Check for Accuracy!
It’s important to check the accuracy of the payment adjustment you will receive in 2019 based on your MIPS 2017 final score and performance feedback.
NextGen Healthcare clients who participated in MIPS in 2017 may submit a MIPS Targeted Review Request to CMS but the deadline to do so is October 15, 2018 at 8:00 p.m. (ET). This includes MIPS eligible clinicians or groups (along with their designated support staff or authorized third-party intermediary), including those who are subject to the APM scoring standard.
Why Request a Review?
The payment adjustment you will receive in 2019 is based on your MIPS 2017 final score. A positive, negative, or neutral payment adjustment will be applied to the Medicare paid amount for covered professional services furnished under the Medicare Physician Fee Schedule in 2019.
If you believe your MIPS 2017 final score—and the subsequent 2019 MIPS payment adjustment calculation—is in error, or incomplete, you can request a targeted review until October 15, 2018. The MIPS Targeted Review process offers the potential to change your MIPS 2017 final score and how that score impacts your 2019 MIPS payment adjustment calculation.
Reasons to request a MIPs Targeted Review may include:
- Errors or data quality issues on the measures and activities you submitted
- Eligibility issues (e.g., you fall below the low-volume threshold and should not have received a payment adjustment)
- Being erroneously excluded from the APM participation list and not being scored under APM scoring standard
- Receiving only partial credit—for one or two components—when you submitted successfully for all three components: IA, PA, and Quality.
- Not being automatically reweighted even though you qualify for automatic reweighting due to the 2017 extreme and uncontrollable circumstances policy
There may be other circumstances, beyond the above bullets, to request a targeted review of your impending MIPS 2019 payment adjustment.
Not sure if you need to submit a targeted review request? Participating NextGen Healthcare clients are encouraged to contact the Quality Payment Program where help is available to determine if you need to submit a targeted review request.