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GOP Doctors Caucus Asks CMS to Reduce MIPS Exemptions

July 10, 2018

McDermott+Consulting

On July 3, 2018, five members of the House Republican Doctors Caucus asked CMS Administrator Seema Verma to reduce the number of clinicians excluded from the Merit-Based Incentive Payment System (MIPS) in 2019.

The letter states that, due in large part to the existing MIPS exemptions, for the 2017 performance year, top performers are estimated to receive an adjustment of just 1.1 percent, even though the statute authorizes bonuses of four percent.  The letter goes on to say that based on feedback from provider groups, the lawmakers are concerned that the low-volume thresholds are too high and preclude providers from earning more than a nominal payment adjustment.  The lawmakers urge CMS to adjust the low-volume threshold to essentially carve in more providers in 2019.

In 2018, roughly 60 percent of clinicians were exempt from MIPS, with many of these excluded because they fell below the low-volume threshold.  The proposed rule that would implement the CY 2019 Quality Payment Program is expected to be released any day.

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