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MGMA to CMS: Notify Clinicians About MIPS Eligibility ASAP

The Medical Group Management Association (MGMA) recently called on CMS Administrator Seema Verma to immediately release Merit-Based Incentive Payment System (MIPS) eligibility notifications as well as approved vendor lists and hospital or patient-facing status. MACRA’s Quality Payment Program launched on Jan. 1, 2017, but eligible clinicians have yet to find out if they qualify to participate in the program’s first performance year under the MIPS track. “Contrary to the Agency’s own regulatory provisions and commitment to providing notifications last December, it is now three months into the 2017 performance period and CMS has failed to notify clinicians and group practices regarding low volume threshold exemptions, status as hospital-based or non-patient-facing, as well as approved lists of registry vendors,” the organization wrote. “Without basic information about eligibility, physicians and medical groups are significantly disadvantaged from positioning themselves for success in the program,” they added. Almost one-third of Medicare clinicians will not qualify to participate in MIPS in 2017 based on low volume thresholds, CMS stated in the MACRA implementation final rule. In total, CMS anticipates about 738,000 to 780,000 clinicians billing under the Medicare Physician Fee Schedule to be excluded from MIPS based on several factors. But the low-volume threshold will exclude the largest number of clinicians. In addition, MGMA pointed out that CMS has failed to release a list of approved data registries for the 2017 MIPS performance year. Like the MIPS exclusion provision, CMS stated in the final rule that it would publish a list of qualified registries and qualified clinical data registries that clinicians could partner with to receive MIPS performance points. MIPS eligible clinicians can use an approved vendor to submit their performance data. Additionally, MGMA urged CMS to release hospital-based and non-patient-facing status notifications. Eligible clinicians that qualify for the two statuses will report on different MIPS measures than other eligible clinicians. MGMA intends for the letter to CMS to expedite the notification process and help eligible clinicians succeed under MACRA.


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