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MIPS 2020 Final Rule: Promoting Interoperability Category

The Promoting Interoperability category is aimed at promoting patient engagement and the electronic exchange of information through CEHRT (certified electronic health record technology). Practices and eligible clinicians reporting for the Merit-based Incentive Payment System (MIPS) must report a minimum of 90 days for this category, although longer periods, including a full year, can be submitted.

MIPS 2020 Final Rule: Improvement Activities

The Improvement Activities (IA) category remains at 15 percent of the total MIPS score.
In activity weights, the medium activity weights are worth 10 points, and the higher activities are worth 20 points. If your practice or eligible clinicians qualify for a special status this year, the medium activity weights are worth 20 points and the high activity points are worth 40. The special status is typically for clinicians in small, rural and underserved practices, or with non-patient facing clinicians or groups.

MIPS 2020 Final Rule: Cost Category

The Cost category for the Merit-based Incentive Payment System (MIPS) reporting seems to be the most confusing, with questions coming from practices throughout the year. The questions will continue as the Centers for Medicare and Medicaid Services (CMS) made the most changes to this category for the 2020 Final Rule.
CMS did keep the Cost category weight of the total performance score at 15 percent instead of the proposed 20 percent, but the category will reweight to 30 percent for the 2022 performance year, as MACRA law mandates that percentage by that year.

MIPS 2020 Final Rule: Quality

As practices move into 2020, reporting on MIPS (Merit-based Incentive Payment System) or not reporting can make a significant difference in reimbursements. To do nothing and not report on any measures can mean a 9.0 percent penalty in Centers for Medicare & Medicaid Services (CMS) payment adjustments for the 2020 reporting year. That +/- 9 percent will remain in effect for each year going forward, according to CMS.

For that reason, the Quality Reporting Engagement Group strongly advises you to report your data to earn a performance score. Even performance scores that just meet the minimum thresholds can avoid a downward adjustment.

Each year CMS adjusts the performance categories. We will address the four categories over a few blogs.

HICN Use Discontinued - Practices Must use MBI for Medicare Reimbursement

For the past 21 months, The Centers for Medicare & Medicaid Services (CMS) has issued MBIs (Medicare Beneficiary Identifiers) to Medicare recipients, replacing the HICN – Health Insurance Claim Number.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) required CMS to remove Social Security numbers (SSN) from all Medicare cards by April 2019. CMS replaced the HICN with a new, randomly generated MBI.

MIPS Promoting Interoperability: How to Earn Bonus Points

Practices may have the opportunity to secure bonus points in the Promoting Interoperability category with Merit-based Incentive Payment System (MIPS) reporting as long as your practice is using e-prescribing for controlled substances and your electronic health record (EHR) vendor is able to track the measures.

MIPS: Quality Bonus Points

There are several opportunities for bonus points in the Quality category for Merit-based Incentive Payment System (MIPS) submissions, which if earned, will be applied to your final category score. The points can be earned simultaneously and are worth up to six points for each bonus category.

MIPS: Cost Category, Feedback Reports and Targeted Reviews

In the Cost category under the Merit-based Incentive Payment System (MIPS), practices do not need to submit data as the Centers for Medicare & Medicaid Services (CMS) relies on using administrative claims data. If your practice met the case minimum for at least one Cost measure, you can access any feedback reports from the Quality Payment Program portal.

MIPS: What You Need to Know About a HARP Account

HARP (HCQIS Access Roles & Profile) replaces the EIDM (Enterprise Identity Management) account on the Centers for Medicare & Medicaid Services’ (CMS) Quality Payment Program portal. The account provides users with a user ID and password to be utilized in the secure identity management portal to access applications like the Quality Payment Program (QPP), Internet Quality Improvement Evaluation System (iQIES) and potentially more in the future.

MIPS: What You Need to Know About the Cost Category

The Cost category for the Merit-based Incentive Payment System (MIPS) may be one of the most misunderstood categories, according to the Quality Reporting Engagement Group.

The Cost category is proposed to increase by 5% each year to eventually be 30% of the MIPS composite score by 2022, as mandated under the MACRA law.  Practices will not have to submit data for this category as the Centers for Medicare & Medicaid Services (CMS) uses administrative claims data to attribute patients and score, so there is no way to avoid being scored in this measure if you meet the case minimum requirements.

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