Aug 15th, 2019
Several changes to the Merit-based Incentive Payment System (MIPS) track of the Quality Payment System (QPP) are outlined in a proposed rule for 2020 revisions to payment policies under the Physician Fee Schedule (PFS). Most of the proposed changes come as no surprise, but there is one proposal, in particular, that will make a huge ...
The Centers for Medicare & Medicaid Services (CMS) released July 3 the 2018 Merit-based Incentive Payment System (MIPS) performance feedback and final score, which includes all MIPS eligible clinician’s or clinician group’s final scores for last year and payment adjustment factors for next year. Depending on how your clinician(s) did, now may be a good ...
In Billing
May 23rd, 2019
Beginning July 2019, oncologists who are part of the Center for Medicare & Medicaid Services’ (CMS) voluntary Oncology Care Model (OCM) who haven’t achieved a performance-based payment (PBP) will be switched from a 1-sided risk model to a 2-sided risk model.   According to an Avalere study, half of those being switched will lose money. Avalere advises ...
Mar 22nd, 2019
Of the 1,057,824 clinicians eligible to participate in the Merit-based Incentive Payment System (MIPS) in the inaugural year, 1,006,319 (95 percent) participated in MIPS and avoided a negative payment adjustment, according to the Centers for Medicare & Medicaid Services’ (CMS) 2017 Quality Payment Program (QPP) Experience Report. The report, which CMS released March 21, provides ...
In Audit
Feb 13th, 2019
Right out of the gate, Medicare Incentive-based Payment System (MIPS) adjustments were incorrectly applied to nonphysician services and supplies. This error is being corrected by the Centers for Medicare & Medicaid Services (CMS), but what if no one caught it? MIPS eligible clinicians and clinician groups could have improperly lost or gained considerable revenue. This ...