FAQs about the Merit-Based Incentive Payment System (MIPS)

david123 By david123, 9th Mar 2018 | Follow this author | RSS Feed | Short URL http://nut.bz/1r7zfavl/
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The merit-based incentive payment system (MIPS) is one of two tracks under the quality payment program, which moves Medicare part B providers to a performance-based payment system.

FAQs about the Merit-Based Incentive Payment System (MIPS)

The merit-based incentive payment system (MIPS) is one of two tracks under the quality payment program, which moves Medicare part B providers to a performance-based payment system. MIPS helps to streamline historical Medicare programs such as:
• Physician quality reporting system (PQRS)
• Value-based payment modifier (VM) program
• Medicare electronic health record (EHR) incentive program

It merged all these programs into a single collective payment system. It allows the eligible clinicians to participate individually or as a group. The qualified clinicians are required to hand their data over to the CMS. The MIPS is fundamentally a performance-based system with four categories that give clinicians the leeway to choose the activities and measures that they consider fundamental to their profession. The clinician's performance is measured based on the four weighted categories to create a composite performance score. This score is used to determine the Medicare part B payment adjustments for the years to come.

Despite seeming straightforward, MIPS is very highly defined and therefore, there are several questions usually asked about them. Here are a few of them to help clear the grey areas.

1. What are the performance categories included in MIPS?
The categories are quality, which replaced the physician quality reporting system (PQRS),advancing care information, which replaced the meaningful use category and cost category which replaced the CMS value-based payment modifier program.

2. What are the consequences of not reporting any data to MIPS?

If you consciously refuse to report data to Merit-based Incentive Payment System(MIPS), there is a -4% payment adjustment to your Medicare part B fee-for-service claims for the coming year. This penalty, however, does not apply to those who qualify for an exemption from MIPS in 2017.

3. Which classes of people are exempt from participation in MIPS?
MIPS outlines that the following classes of people are exempt from MIPS.
• Clinicians who are below the low volume threshold
• Newly enrolled Medicare-eligible clinicians who are in the first performance year
• Eligible clinicians who are participating in advanced APMs
4. How is the data submitted to MIPS treated?

When there are concerns about the privacy of patient data, it should be known that the data is handled with regard to the standing orders on disclosure, privacy, and security. The information is not processed by any third party but directly managed by CMS.
When reporting as an individual, how do I gather data from two locations that use different data collection methods?

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Mips, Payment System

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