MIPS Reporting Deadline: Time’s A-Ticking for Data Submission

By Moshe Starkman, Senior Director, Value-based Reimbursements | Posted: 01/19/2018


Are you feeling behind the curve when it comes to the looming March 31st data submission deadline for MACRA’s Quality Payment Program (QPP) Merit-based Incentive Program (MIPS)? Have no fear, there’s still time to submit your data and avoid the negative payment adjustment.

With the March 31, 2018 data submission deadline just around the corner, here’s key information you need to know to avoid a negative reimbursement adjustment of four percent.

QPP: Two Paths

The Quality Payment Program is a new payment system that provides financial rewards to Medicare clinicians who deliver exceptional quality care at managed costs. There are two paths to success under the QPP, the first is the Merit-based Incentive Payment System (MIPS) and the other are models under an Advanced Alternative Payment Models (APMs) banner.

Clinician Eligibility

For the 2017 Performance Year 1, eligible clinicians (ECs) can participate in MIPS as an individual or as a group, e.g., TIN. The ECs who bill more than 25 percent of their charges through an APM will achieve the status of Qualifying APM Participant (QP) and will be exempt from MIPS reporting requirements.

To be eligible for MIPS reporting, an EC must bill more than $30,000 a year in Medicare Part B allowed charges and provide care for more than 100 Part-B enrolled Medicare beneficiaries in 2017.

Eligible clinicians include:

  • Chiropractors
  • Doctors of Dental Surgery
  • Doctors of Dental Medicine
  • Doctors of Medicine
  • Doctors of Optometry
  • Doctors of Osteopathy
  • Doctors of Podiatric Medicine
  • Physician Assistants
  • Nurse practitioners
  • Clinical nurse specialists
  • Certified registered nurse anesthetists
  • Groups that includes such clinicians

Eligible clinicians should participate in Performance Year 1 to avoid a negative payment adjustment and potentially earn a positive payment adjustment. Not participating will result in a full downward payment adjustment of four percent.

To determine whether you should participate in MIPS this year, use the MIPS Look-Up Tool on the CMS website.

MIPS Reporting Requirements

Under MIPS, clinicians are required to report data for three of four MIPS performance categories: Quality, Improvement Activities and Advancing Care Information. The fourth category, Cost, does not require any additional submissions and is based on administrative claims data.

There are multiple mechanisms to submit data including through a MIPS Qualified Registry such as nThrive.

For Performance Year 1, a clinician or group can choose to submit data in one of three ways:

  1. Submit data covering a full year, or
  2. Submit data covering a consecutive 90-day period, or
  3. Submit a minimum amount of data

Ready to get started?

nThrive recommends all eligible clinicians report data for Performance Year 1. If you participate in MIPS by submitting data for at least 90 days, you will avoid the negative payment adjustment and will be eligible for a positive payment adjustment. If you are eligible to participate but choose not to, you will receive a negative four percent payment adjustment on your 2019 charges.

With nThrive’s help, you can avoid a penalty and potentially earn an incentive or bonus. Our streamlined MIPS Registry reporting solution will help you avoid the penalty and find success, even with the upcoming March submission deadline.

Contact us here or call us at (678) 323-2500 to speak to a MIPS advisor today.

To learn more about nThrive’s customized MIPS Data Submission Registry, click here.

Are you interested in learning more about MACRA MIPS requirements? View previous MACRA webinar sessions.