CMS miscalculated MIPS payment adjustments: 4 things to know

CMS recently disclosed it made an error when processing quality scores for physicians participating in the Merit-based Incentive Payment System. 

Here are four things to know:

1. CMS recently released feedback for physicians included in MIPS during the 2017 performance year. The agency also launched the targeted review process, which allows providers to request a review of their MIPS payment adjustment factors if they believe there is an error with the 2019 MIPS payment adjustment calculation.

2. "The requests that we received through targeted review caused us to take a closer look at a few prevailing concerns," CMS said. "Those concerns included the application of the 2017 Advancing Care Information and Extreme and Uncontrollable Circumstances hardship exceptions, the awarding of Improvement Activity credit for successful participation in the Improvement Activities Burden Reduction Study, and the addition of the All-Cause Readmission measure to the MIPS final score."

3. CMS reviewed the concerns and identified "a few errors in the scoring logic and implemented solutions," the agency said. Correcting the mistakes resulted in changes to the 2017 MIPS final score and associated 2019 MIPS payment adjustment for some clinicians. CMS did not disclose how many physicians were affected or how much providers were overpaid or underpaid as a result of the errors.

4. CMS extended the targeted review deadline from Sept. 30 to Oct. 15 to give physicians more time to access and review their performance feedback.

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