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CMS Identifies Error in Application of 2019 MIPS Payment Adjustment

February 13, 2019

McDermott+Consulting

On February 9, 2018, Congress passed the Bipartisan Budget Act of 2018, which contained provisions that made several changes to the Merit-based Incentive Payment System (MIPS) track of the Quality Payment Program (QPP). Changes included limiting the application of the MIPS payment adjustment to professional services and excluding its application to items such as Part B drugs. Recently, the Centers for Medicare and Medicaid Services (CMS) discovered an error in the application of the 2019 MIPS payment adjustment where Medicare Administrative Contractors (MACs) applied the adjustment to Part B drugs.

CMS has indicated that they are working to resolve this issue and that no action is requested of clinicians. In the event that CMS overpaid a claim based on inclusion of the Medicare Part B drugs, a notification for recoupment will be issued from their MAC on behalf of CMS.

More information is available on the QPP website.

 


For more information visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at 202-204-1459 or smadhani@mcdermottplus.com.

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