All of a Sudden, One Month Less for Claims-Based MIPS Reporting
By David Doolittle

2.14 deadlineThe Centers for Medicare & Medicaid Services (CMS) recently moved the MIPS deadline for claims reporting from March 31 to March 1.

That’s right: If you planned to report data through the claims-based submission method for the quality performance category of the 2017 Merit-Based Incentive Payment System (MIPS), you now have about two weeks to do so.

Meeting this deadline is important: Missing it means you’ll incur a 4-percent Medicare payment cut per claim in 2019.

The new deadline is only for physicians who are participating in MIPS at the individual reporting level and have chosen to submit data for the MIPS quality category through Medicare Part B claims for dates of service in 2017.

All other MIPS-eligible physicians and practices have two Quality Payment Program (QPP) deadlines: March 16 for practices using the CMS web interface and March 31 for all other data submission methods. 

So what’s up with CMS’ abrupt notice of the new deadline? TMA is looking into it, but here’s what we know: 

  1. Since 2016 and up until last week, CMS had announced and published in all its emails, fact sheets, and guides, and on its website that the reporting deadline for MIPS is March 31. That’s what we’ve been telling TMA member-physicians.
  2. In early January, CMS launched the new QPP portal and announced that the reporting deadline for all reporting methods but the web interface method is March 31; all of a sudden, the deadline for those using the web interface method became March 16.
  3. Then on Feb. 9, CMS announced in an email that the deadline for claims-based reporting is March 1. 

The agency has given no explanation for the changes.

So what should you do if you plan to report via claims but still haven’t? Reporting the bare minimum for the 2017 MIPS quality category before March 1 is enough to avoid a penalty. This option allows you to report data on as little as one quality measure for at least one patient with a date of service in 2017.

For details on how to report data through a CMS-1500 form or CMS-1450 electronic form, refer to this step-by-step guide and CMS fact sheet. Claims processed by Novitas must get to the national Medicare claims system data warehouse (National Claims History file) by March 1 to be analyzed for MIPS for the 2017 QPP performance year.

Meanwhile, if you’ve already submitted quality data via claims, CMS says you can now view your performance scores on the new QPP portal. Using the information in this CMS fact sheet, sign in to new QPP portal to see your scores for each MIPS quality measure you reported on for the 2017 QPP performance year. However, CMS states that scoring of claims data is subject to change monthly based on the processing of any additional 2017 claims and adjustments up to 90 days after the end of 2017. So check your scores again after the close of the data submission window. 

Other reporting options include the qualified registry, qualified clinical data registry, electronic health record (check with your vendor) or attestation on the new QPP portal. If you use these options, all data must be submitted to CMS by March 31. You can find 2017 resources for each reporting method on the CMS website

Photo: www.acacompliancegroup.com

Last Updated On

February 14, 2018

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David Doolittle

Editor

(512) 370-1385

Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

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