Deadline approaching for submitting data to CMS

Amy Mullins
Amy Mullins

Eligible clinicians have until March 31 to submit their 2017 Merit-based Incentive Payment System, or MIPS, data to CMS.

Clinicians should decide now — not March 30 — if they want to participate, Amy Mullins, MD, the American Academy of Family Physicians’ medical director for quality improvement, told Healio Family Medicine.

“CMS is using a technology-based system to get MIPS data. Sometimes technology fails. I would not want to wait until the last minute to rely on a website to be 100% available at the last minute and up to speed,” she said in an interview. “I would encourage people to familiarize themselves with the website, the CMS portal, create a login, and begin submitting what they have now. I wouldn’t encourage anyone to wait until the last minute and hope that they can get the reporting process done in time.”

According to CMS, the following health care professionals are encouraged to submit MIPS data from Jan. 1, 2017 through Dec. 31, 2017 to CMS: doctors of medicine, osteopathy, podiatry, optometry, dental surgery, dental medicine, chiropractors, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and group(s) that include such clinicians.

Practitioners from this same group must also bill $30,000 or more in Medicare Part B allowed charges a year or provide care to more than 100 Part B-enrolled Medicare beneficiaries a year to be eligible to participate in MIPS, according to CMS.

These professionals have four different reporting categories: quality, cost, improvement activities and advancing care information, Mullins said, adding that CMS’ decision to count the cost category as 0% of the 2017 score “sets an achievable threshold” for the first year of the program.

“MIPS reporting is not as complicated or time-consuming now as it could potentially be moving forward,” Mullins cautioned. “By just reporting on one of those other categories on at least one patient to CMS, you avoid a 4% negative adjustment on your Medicare Part B claims and possibly qualify for a positive adjustment.”

An online tool, qpp.cms.gov and an AAFP guide are available to help eligible clinicians through the finer details of the process, but AAFP is still fielding some questions on the issue, Mullins said.

“A lot of people are seeking to clarify the type of data that needs to be submitted. They’re also asking things like ‘Do I really only have to submit one piece of data for 2017 to avoid the penalty in 2019?’ Sometimes they don’t believe that’s true, and they want to make sure they are doing this correctly,” she said in the interview. “We encourage eligible clinicians to submit as much data as possible, because then they might score higher, and get a better positive adjustment than they might think.”

MIPS is one track of the Quality Payment Program established by the Medicare Access and CHIP Reauthorization Act, also known as MACRA. The act replaces the Sustainable Growth Rate formula, and was touted as changing how Medicare payments are tied to the cost and quality of care when HHS finalized the act almost 18 months ago. - by Janel Miller

Disclosure: Mullins is AAFP’s medical director for quality improvement.

Amy Mullins
Amy Mullins

Eligible clinicians have until March 31 to submit their 2017 Merit-based Incentive Payment System, or MIPS, data to CMS.

Clinicians should decide now — not March 30 — if they want to participate, Amy Mullins, MD, the American Academy of Family Physicians’ medical director for quality improvement, told Healio Family Medicine.

“CMS is using a technology-based system to get MIPS data. Sometimes technology fails. I would not want to wait until the last minute to rely on a website to be 100% available at the last minute and up to speed,” she said in an interview. “I would encourage people to familiarize themselves with the website, the CMS portal, create a login, and begin submitting what they have now. I wouldn’t encourage anyone to wait until the last minute and hope that they can get the reporting process done in time.”

According to CMS, the following health care professionals are encouraged to submit MIPS data from Jan. 1, 2017 through Dec. 31, 2017 to CMS: doctors of medicine, osteopathy, podiatry, optometry, dental surgery, dental medicine, chiropractors, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and group(s) that include such clinicians.

Practitioners from this same group must also bill $30,000 or more in Medicare Part B allowed charges a year or provide care to more than 100 Part B-enrolled Medicare beneficiaries a year to be eligible to participate in MIPS, according to CMS.

These professionals have four different reporting categories: quality, cost, improvement activities and advancing care information, Mullins said, adding that CMS’ decision to count the cost category as 0% of the 2017 score “sets an achievable threshold” for the first year of the program.

“MIPS reporting is not as complicated or time-consuming now as it could potentially be moving forward,” Mullins cautioned. “By just reporting on one of those other categories on at least one patient to CMS, you avoid a 4% negative adjustment on your Medicare Part B claims and possibly qualify for a positive adjustment.”

An online tool, qpp.cms.gov and an AAFP guide are available to help eligible clinicians through the finer details of the process, but AAFP is still fielding some questions on the issue, Mullins said.

“A lot of people are seeking to clarify the type of data that needs to be submitted. They’re also asking things like ‘Do I really only have to submit one piece of data for 2017 to avoid the penalty in 2019?’ Sometimes they don’t believe that’s true, and they want to make sure they are doing this correctly,” she said in the interview. “We encourage eligible clinicians to submit as much data as possible, because then they might score higher, and get a better positive adjustment than they might think.”

MIPS is one track of the Quality Payment Program established by the Medicare Access and CHIP Reauthorization Act, also known as MACRA. The act replaces the Sustainable Growth Rate formula, and was touted as changing how Medicare payments are tied to the cost and quality of care when HHS finalized the act almost 18 months ago. - by Janel Miller

Disclosure: Mullins is AAFP’s medical director for quality improvement.