2018 MIPS Year Two Final Rule

There has been much debate about what changes would be made to the MIPS program for the second reporting period after the 2018 Proposed Rule came out earlier this year.  The Final Rule for the 2018 Quality Payment Program was announced on Thursday, November 2nd.  Many of the proposed rule changes were upheld by CMS.  The quality payment program will ease the burden for small practices and continue to transition toward a more robust program when MIPS will expand in year 3. Here are some key takeaways from the final ruling.

– The addition of the Cost Performance Category will be added in 2018.

– The Quality Performance Category weighting has been reduced.

– The minimum performance threshold has been raised in year 2.

– Practices using 2014 Edition certified software will be able use their CEHRT for the 2018 reporting period. Clinicians can use either 2014, 2015 or a combination of the two certified editions, however a bonus can be earned by using only a 2015 CEHRT.

– Clinicians treating complex patients will automatically be awarded up to 5 bonus points.

– Small practice clinicians will receive a 5-point bonus.

– Virtual groups have been added as a reporting option.

– Adjustments to MIPS eligibility requirements will exclude those providers with≤$90,000 in Part B allowed charges or ≤200 Medicare Part B beneficiaries.

Some of the transitional features of the 2017 reporting year will carry over for the next reporting period. In 2017 providers could choose to submit a minimum amount data to avoid penalty. The performance threshold remains low but has been increased from 3% to 15%. Like the transition year, meeting this threshold allows providers to avoid MIPS penalties. New to the program for the 2018 year will be the Cost performance category. This new scoring section will represent of 10% of the final MIPS year two score, giving providers another opportunity to increase their chances of reimbursement bonus.  As a result of the new performance category, the weighting of the Quality Performance category will be reduced to 50%.

Two of the most important changes for 2018 include the reduction in number of eligible clinicians and the addition of Virtual group reporting. CMS received a lot of feedback from small practices and individual providers that addressed the added burden of participation in MIPS. To ease this burden the decision was made to increase the eligibility requirements to exclude those providers with less than $90,000 in Medicare Part B charges and fewer than 200 beneficiaries. In addition to raising the participation requirements CMS has allowed participation through Virtual groups.  Eligible individual providers may participate within a group with different TINs.

You can read more about the Final Rule which is available through the CMS webpage. If you’d like to know how you can take advantage of the MIPS program to increase your Medicare reimbursement call Access1 today. A MIPS coach will help you plan for the 2018 reporting period and review your 2017 status.