Take Action Now to Avoid 2019 Medicare Payment Penalty
By David Doolittle

For a lot of people, the start of a new year is a time to reflect on the past while looking ahead to the future.

MACRA January photoBut as a busy physician, you might have time to concentrate on only one or the other.

Wouldn’t it be great if focusing on what you did in 2017 could affect how much you get paid in 2019?

Well, good news, my time-constrained friend: That’s exactly how Medicare’s Quality Payment Program (QPP) works. 

All you have to do is submit your 2017 data to the Centers for Medicare & Medicaid Services (CMS) by March 31 to avoid a 4-percent Medicare payment penalty in 2019.

That’s the case if you participate in the Merit-Based Incentive Payment System (MIPS) or an alternative payment model (APM). The best news is that if you have done nothing to date, it is still possible to participate.

To get started, access the MIPS lookup tool to find out if you are exempt for the 2017 performance year. Then check the list of 53 Texas counties affected by Hurricane Harvey to see if you qualify for a separate MIPS exemption. 

Once you’ve figured that out:

  • Create or update your Enterprise Identity Data Management (EIDM) credentials to sign in to the new QPP portal. You’ll need an account to submit data to CMS yourself, to see what your vendor submitted on your behalf, and/or to access performance feedback reports. NOTE: Establishing an EIDM account may take several weeks, so you might want to start now. 
  • To participate in MIPS, refer to this TMA article for steps on how to submit your 2017 data.
  • If you partcipated in an APM in 2017, check out the APM lookup tool and contact your APM administrator to ensure all required data specific to your model will be sent to CMS on your behalf.

 For education and technical assistance, check out these resources: 

  • For a general overview of the QPP, explore the CMS QPP website
  • For comprehensive education on how to navigate the QPP (MIPS and APMs), visit the Physicians Advocacy Institute’s MACRA QPP Resource Center
  • To communicate with QPP experts, join TMF Health Quality Institute’s learning and action network for no-cost technical assistance and education via a web-based platform. TMF also offers free access to a MIPS Toolbox you can use to submit MIPS data to CMS. 
  • For customized on-site assistance to help with your practice’s specific needs, TMA Practice Consulting offers personalized quality improvement services and a MACRA readiness assessment to help prepare your practice for the QPP. 

So there ya go. Two birds. One stone. Four percent saved.

If you have any other questions, contact the CMS QPP Service Center at (866) 288-8292 or by email at QPP[at]cms[dot]hhs[dot]gov. For more information, visit the TMA MACRA Resource Center.

Last Updated On

January 04, 2018

Originally Published On

January 04, 2018

Related Content

MACRA | Medicare | Quality reporting

David Doolittle


(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.

More stories by David Doolittle