MIPS and MACRA March Madness | Geneia

MIPS & MACRA March Madness

March 22, 2018
Heather Lavoie, Chief Strategy Officer

MACRA Deadline Extended

Who does this deadline apply to?

The March 31 now April 3rd deadline applies to all MIPS (Merit-based Incentive Payment System)-eligible clinicians, except those granted a hardship exception, such as those approved for clinicians impacted by last year’s natural disasters.

To check your MIPS eligibility status, enter your National Provider Identifier (NPI) into the Centers for Medicare and Medicaid Services (CMS) MIPS Lookup Tool.

What is due?

MIPS-eligible clinicians must submit their 2017 performance data:

What are the consequences?

Meeting this deadline means you can potentially earn a positive payment adjustment in 2019:

  • Submit a minimum amount of data as a test to avoid a downward payment adjustment
  • Submit 90 days of data to earn a neutral or positive payment adjustment (may even earn the maximum)
  • Submit the full 2017 year of data to earn a neutral or positive payment adjustment

Missing this deadline results in an automatic 4-percent reduction in Medicare Schedule B payments in 2019.

Image of MIPS 2018 Timeline. 

What does this mean to you?

Table stakes this year are +/- 4 percent of your Medicare Part B billings.

Understanding the impact is a simple calculation – estimate your Medicare Part B billing and multiply by 4% (0.04).

If you are eligible and do nothing, the result is your approximate penalty.

If you are eligible and report for a minimum of 90 days, the result is the maximum upward adjustment.

Note: this does not account for any high-performance bonus you may earn, which is up to an additional 10-percent.

Over the next few years, the bonus/penalty percentage will more than double. 

How do I submit?

  1. Have your CMS Enterprise Identity Management (EIDM) credentials available. Note, if you previously reported under legacy programs such as Physician Quality Reporting System (PQRS), you already have an EIDM account. If not, signing up for one enables you to access multiple CMS systems with a single ID.
  2. With your EIDM information, sign in to the Quality Payment Program (QPP) submission portal.
  3. The portal will recognize you and connect your NPI to your associated Taxpayer Identification Numbers (TINs).

Submission tips

Submit early and often. There is no ‘save’ or ‘submit’ button; information continuously updates as you enter your data. This means you can see your scores update in real time and add additional information to address problem areas before the deadline.

If you haven’t already, start entering data now. The earlier you start, the more time you have to address technical problems.

Note this deadline is for the submission of 2017 data only.

If you belong to an ACO or other APM, ensure your administration has all the patient records they need from you and be aware that you are responsible for submitting Advancing Care Information measures yourself. 

For more information

For additional insights and help with MACRA reporting:

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