Promoting Interoperability

  • What Is Promoting Interoperability?

    The Promoting Interoperability (PI) category of the Merit-Based Incentive Payment System (MIPS) requires physicians to attest annually to meeting certain measures prescribed by the Centers for Medicare and Medicaid Services (CMS). The 2024 performance year impacts Medicare Fee for Service payments in 2025.

    In 2024, performance measurement in the MIPS program will be based on four weighted categories.

    • Quality (30%),
    • PI (25%)
    • Improvement activities (15%), and
    • Cost (30%).
    Learn How MIPS Works
  • CMS Adds Cyberattack Hardship Option to MIPS EUC

    Due to the ongoing impact the Change Healthcare Cyberattack has had on physician practices, CMS has added an option to cite the cyberattack when requesting the 2024 Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances (EUC) hardship exception.

    To account for the increased number of physicians that have been impacted by a cyberattack this year, CMS has specifically added a drop-down tab in the application to indicate the EUC is due to the Change cyberattack. When in the EUC portal, physicians should select the event type as “ransom/malware”. Once a physician clicks on the event type “ransom/malware” a drop-down box will appear asking whether the event pertains to the Change Healthcare Cyberattack. Reference page 8 in the 2024 MIPS EUC Application User Guide for more details. The 2024 MIPS EUC portal is now open, and physicians have until December 31, 2024, to file a hardship application and avoid a 2026 MIPS negative payment adjustment.

    When applying for a hardship, physicians have the option to request reweighting of up to four MIPS categories. Reweighting of all performance categories will result in avoiding a MIPS penalty of up to -9 percent in 2026. As a reminder, if a physician or group submits data, it will override the hardship exception and the physician or group may be scored.

  • How Do I Meet the PI Requirements?

    To meet the requirements of the PI category, an EHR is required.

    • If you do not currently use an EHR, you will have to select, purchase, and implement an EHR. Be sure the product you select is certified. TMA has numerous resources to help practices with selection.
    • If you currently use a certified EHR, check with your EHR vendor to ensure the product you use meets the ONC health IT certification criteria. View the list of certified products here.
  • 2024 PI Objectives and Measures

    For 2024, eligible clinicians must use technology that meets the ONC health IT certification criteria.

    Participants must submit collected data for certain measures from each of the measures (unless an exclusion is claimed) for 180 continuous days or more during 2024. It was previously 90 days with 2024 being the first year that the data collection requirement is increased to 180 days.

    In addition to submitting data on the measures, clinicians must positively attest to:

  • Resources for Objectives and Measures

    Use the following resources to meet the PI objectives and measures. 

    E-prescribing

    Health Information Exchange

    Provider to Patient Exchange

    Public Health and Clinical Data Exchange

    Security Risk Analysis

     

  • Reporting Options

    Notes: 

    • Be sure to ask your EHR vendor about MIPS reporting options.
    • You don’t have to use the same reporting mechanism for all MIPS categories. For example, you can report PI via attestation, but submit quality measures via a qualified registry. 
    • When using the Group Reporting option, you must use the same identifier for all reporting methods. For example, you cannot individually report PI and then group report quality measures.
  • Don't Forget About Audits

    CMS could tap you for a MIPS audit in the future. Here are some things to know to prepare your practice.

    • Document everything (take screen shots)
    • Maintain documentation for 6 years
    • Maintain practice email addresses for notification

    Yes, You Do Have to Comply With a MIPS Audit Request Texas Medicine Today, Aug. 14, 2019

    Audit Readiness – What You Need to Know (TMF Quality Innovation Network)

    Learn More About Audit Documentation

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    TMA is helping to strengthen your practice by offering advice and creating a climate of medical success across the state. 

  • What could a TMA membership mean for you, your practice, and your patients?