Now Available: MIPS 2017 Performance Feedback and Final Score; Process for Targeted Review; EIDM Account Creation

CMS is out with MIPS 2017 Performance Feedback and Final Score. All Medicare practitioners and groups who had submitted MIPS 2017data can check their MIPS 2017 Performance Score released by CMS recently.

MIPS 2017 Performance Score is available to clients from QPP website by logging into QPP Portal  https://qpp.cms.gov/ with the same EIDM credentials that allowed submitting and viewing data during the submission period.

If you do not have your QPP Portal Account set up, please create one before 30th July 2018 (using the EIDM User Guide).

You can check if you have received Positive, Neutral or Negative Payment adjustment and how much is it (between -4 to +4). This is going to directly impact your 2019 Medicare Fee Schedule.

IMP: Once you check your Performance score and feel that it is incorrect, you can request a Targeted review before Sept 30th, 2018 by filling out a form and submitting it along with appropriate documentation. For more information about what qualifies for Targeted Review and how to request a targeted review, please refer to the Targeted Review of the 2019 Merit-based Incentive Payment System Payment Adjustment Fact Sheet and the Targeted Review of 2019 MIPS Payment Adjustment User Guide through links given below.

CMS has posted an additional resource on CMS.gov to help eligible clinicians and groups understand their Merit-based Incentive Payment System (MIPS) 2019 payment adjustment based on their 2017 performance.

The 2019 MIPS Payment Adjustment Fact Sheet highlights how CMS assigns final scores to MIPS eligible clinicians, and how payment adjustment factors are applied for 2019 based on 2017 MIPS final scores.

Important Dates:

  1. Creation of EIDM account to check 2017 MIPS Performance Feedback and Final Score: Before 31st July 2018
  2. Submission of Targeted Review: Before 30th Sept 2018

PrognoCIS Support:

Kindly feel free to contact PrognoCIS Support in case you need any help in creating EIDM Account, understanding Performance Feedback, Final Score or submitting Targeted Review.

Ticket: Resource Center > Manage Support Cases

Ph: 1-800-552-3301 / 1-408-873-3032
Email: qppsupport@bizmaticsinc.com

Resources:

Following are links to some of the important documents:

  1. 2017 Performance Feedback User Guide
  2. EIDM User Guide
  3. Targeted Review of the 2019 Merit-based Incentive Payment System Payment Adjustment Fact Sheet
  4. Targeted Review of 2019 MIPS Payment Adjustment User Guide
  5. 2019 MIPS Payment Adjustment Fact Sheet

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Details from CMS:

MIPS Performance feedback and final score on QPP Portal:

You can access your performance feedback and final score by:

  • Accessing the Quality Payment Program website https://qpp.cms.gov/
  • Logging in using your Enterprise Identity Management (EIDM) credentials; these are the same EIDM credentials that allowed you to submit your MIPS data

 

If you don’t have an EIDM account, refer to EIDM User Guide and start the process now:

Last date for creating EDIM Account:

 Don’t have an EIDM account? Don’t wait. Start the process now to ensure you can access MIPS performance feedback in a timely manner, and if necessary submit a request for targeted review if you believe there are errors in your final score or payment adjustment. Please see the Frequently Asked Questions section for more information on EIDM.

We strongly encourage clinicians and practice representatives to obtain the necessary EIDM credentials no later than July 31, 2018.

Please note: The final performance year for the Value-Based Modifier and Physician Quality Reporting System (PQRS) programs was 2016; therefore, CMS will no longer provide PQRS Feedback Reports or Quality and Resource Use Reports (QRURs). The final reports under these programs were provided in September 2017 and remain available for download through the end of this year.

 

MIPS 2017 Performance Feedback User Guide:

The 2017 Performance Feedback User Guide consists of the following –

  • Discusses who can access MIPS performance feedback
  • Highlights the differences between preliminary performance feedback and final performance feedback; and
  • Provides step-by-step instructions for accessing your feedback

 

2017 Performance Feedback Fact Sheet:

What is Included in My Final MIPS Performance Feedback?

Final MIPS performance feedback will include the following information for each individual clinician, group, or APM Entity:

  • 2017 final score
  • 2019 MIPS payment adjustment applied to MIPS eligible clinicians (Note that payment adjustments will not be applied to voluntary submitters)
  • Final performance category scores and weights

 

In addition to the final score and payment adjustment information, final MIPS performance feedback will also include:

  • Scoring and performance details for Quality and Advancing Care Information measures
  • Scores for Improvement Activities
  • Performance details for Cost measures (informational only for 2017, not applicable to MIPS eligible clinicians who are scored under the APM scoring standard)
  • Items and services (information about Emergency Department utilization for attributed beneficiaries) (This information has no impact on your MIPS score)

 

MIPS Targeted Review, Payment Adjustment, and Performance Feedback Resources

MIPS eligible clinicians or groups (along with their designated support staff or authorized third- party intermediary), including those who are subject to the APM scoring standard, may request for CMS to review their performance feedback and final score through a process called targeted review.

 

When to Request a Targeted Review 

If you believe an error has been made in your 2019 MIPS payment adjustment calculation, you can request a targeted review until September 30, 2018. The following are examples of circumstances in which you may wish to request a targeted review:

  • 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 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

Note: This is not a comprehensive list of circumstances. CMS encourages you to submit a request form if you believe a targeted review of your MIPS payment adjustment (or additional MIPS payment adjustment) is warranted.

 

How to Request a Targeted Review

You can access your MIPS final score and performance feedback and request a targeted review by:

  • Going to the Quality Payment Program website
  • Logging in using your Enterprise Identity Management (EIDM) credentials; these are the same EIDM credentials that allowed you to submit your MIPS data. Please refer to the EIDM User Guide for additional

When evaluating a targeted review request, we will generally require additional documentation to support the request. If your targeted review request is approved, CMS will update your final score and associated payment adjustment (if applicable), as soon as technically feasible. CMS will determine the amount of the upward payment adjustments after the conclusion of the targeted review submission period. Please note that targeted review decisions are final and not eligible for further review.

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 Sheet and the Targeted Review of 2019 MIPS Payment Adjustment User Guide

For More Information