CMS has yet to release 2017 MIPS eligibility requirements

Almost three months into the Medicare Access and CHIP Reauthorization Act's first performance year, CMS has still not released eligibility information for the Merit-Based Incentive Payment System, one of two tracks under the law.

The agency has not notified clinicians about low-volume threshold exemptions from the program — which CMS estimated would affect one-third of eligible clinicians — as well as other provisions of MIPS, including hospital-based or non-patient facing status, approved vendor lists and qualified clinical data registries, according to the Medical Group Management Association.

MGMA sent a letter Wednesday to CMS Administrator Seema Verma calling for the immediate release of this information. "This is generating considerable frustration and confusion," Anders Gilberg, MGMA senior vice president of government affairs, wrote. "Without basic information about eligibility, physicians and medical groups are significantly disadvantaged from positioning themselves for success in the program."

Under MIPS, providers who bill $30,000 or less to Medicare or serve 100 or less Medicare patients are exempt from the program in 2017. To help provide notice in advance, CMS planned to use historic data to determine exemption and inform providers of their status a month before the performance period begins, according to MGMA. This would have been in December.

"To succeed in MIPS, clinicians and group practices require certainty as to their eligibility, as well as the eligibility of their vendor partners. We urge CMS to expeditiously release these long overdue MIPS eligibility notices and approved vendor lists," Mr. Gilberg wrote.


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