MIPS Reporting
What you need to know?
By Ritu Bhatnagar
Every year Medical practices scramble for answers and end up with more questions when it comes to the reporting requirement under Affordable Care Act (ACA). MIPS is an acronym for Merit Based Incentive Payment System and CMS has been changing the instructions & requirements for reporting clinical data every year. This leads to confusion and questions, this is my attempt to help you understand more about MIPS/MACRA for 2018 in a summarized form.
Most of the providers are not aware that they might NOT be qualifying to report MIPS data this year. The first thing a practice/physician should do is confirm if they qualify. This information can be confirmed on the CMS website.
Clinicians Included in MIPS
- Physicians (including Doctor of Medicine, doctors of osteopathy, osteopathic practitioners, Doctor of Dental Surgery, doctors of dental medicine, doctors of podiatric medicine, doctors of optometry, and chiropractors)
- Physician assistants
- Nurse practitioners
- Clinical nurse specialists
- Certified registered nurse anesthetists
- Groups or virtual groups that include one or more of the clinician types above
- Groups and clinicians should only report MIPS data if they qualify
Basic qualifying criteria for any clinician:
- Joined Medicare before 2018
- Has seen more than 200 Medicare patients
- Billed Medicare for more than $90,0000
MIPS Reporting
To avoid a penalty in 2018, you must submit MIPS measures that total at least 15 MIPS points from one category, or a combination of categories. You’ll receive a negative reduction of up to -5% for not reporting or not reporting at least enough data to earn 15 MIPS points.| To Avoid A Penalty In 2018, You’ll Need to Earn At Least 15 Points |
