Medical Billing Blog

Physician Groups Ask CMS for MIPS Guidance...Quickly!

Posted by Scott Shatzman on Wed, Mar, 22, 2017 @ 14:03 PM

Physicians participating in the Merit-based Incentive Payment System have yet to receive eligibility notifications that the Centers for Medicare and Medicaid Services should have sent in December, according to the Medical Group Management Association.

Nor have physicians received their status as hospital-based or non-patient-facing clinicians, or received lists of approved registry vendors for reporting purposes.

An MGMA letter highlighted these issues and is urging the federal agency to act quickly to get essential information to physicians who will be reimbursed under the new system.

“Transitioning to MIPS is a challenge involving upgrades to electronic health records software, re-engineering clinical workflows to meet data capture and reporting requirements, contracting with data registries, and training clinical and administrative staff,” MGMA told CMS in its recent letter. “Without basic information about eligibility, physicians and medical groups are significantly disadvantaged from positioning themselves for success in the program.”

In fact, one third of Medicare providers still are not sure if they qualify for MIPS, according to MGMA, which cited CMS’s own numbers. Even those that believe they can participate in MIPS are waiting for information from the agency—CMS has not issued final lists of approved registries. “Group practices planning to utilize these reporting mechanisms must either delay engagement or partner with vendors without a guarantee they meet CMS’s qualifications.”

Lastly, MGMA reminded CMS that success in MIPS requires providers to have certainty of their eligibility and the eligibility of their vendors, and the organization urged quick release of eligibility notices and approved vendor lists.

While MGMA seeks a more expeditious release of information related to MIPS, just a month ago the group joined 15 other provider associations in asking HHS Secretary Tom Price for indefinite delays in the EHR Stage 3 Meaningful Use program as well as measures that are similar to Stage 3 that are in MIPS.

“Our members are very concerned with the unrealistic timeframe and the difficult-to-meet requirements laid out in Stage 3 of the Meaningful Use program, as well as with the related requirements under MIPS,” member associations told Price.

CMS issued the following statement in response to MGMA’s concerns:

“CMS has committed to letting clinicians know whether or not they meet the volume thresholds for participation in the Merit-based Incentive Program this spring. Clinicians need this predictability so that they can plan for the first year of the program. As part of this commitment, CMS must ensure that what we send to clinicians is understandable so that clinicians and practices can rely on this information to make decisions. CMS is actively working with clinicians in the field to receive feedback on the information we plan to send out and we have received valuable input to ensure that we are sending out letters with easy-to-understand, actionable information.”


This article originally appeared on Health Data Management.