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CMS Extends Deadline for MIPS Targeted Review to October 1, 2018

July 17, 2018

McDermott+Consulting

The Centers for Medicare & Medicaid Services (CMS) recently released 2017 Merit-based Incentive Payment System (MIPS) performance feedback. The 2017 MIPS performance feedback, reflecting activities in performance year one of the QPP (2017), will indicate if MIPS participants receive a negative, neutral or positive payment adjustment in 2019.

Clinicians who believe an error has been made in their 2019 MIPS payment adjustment calculation, can request a targeted review until October 1, 2018. The following are examples of circumstances in which a targeted review can be requested: 

  • 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 Alternative Payment Model (APM) participation list and not being scored under APM scoring standard
  • Not being automatically reweighted even though you qualify for automatic reweighting due to the 2017 extreme and uncontrollable circumstances policy

For more information about how to request a targeted review, please refer to the Targeted Review of the 2019 Merit-based Incentive Payment System Payment Adjustment Fact Sheetand the Targeted Review of 2019 MIPS Payment Adjustment User Guide.

CMS has also recently released a MIPS 2017 Performance Feedback Users Guide. This document provides detailed information on accessing performance feedback and guidance on interpreting the information provided in the feedback. This resource is in addition to the previously released MIPS Performance Fact Sheet.

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