The Good, the Bad, and the MIPS Exempt for 2018
By David Doolittle


Thanks to advocacy by the Texas Medical Association and others, more physicians are exempt from participating in the 2018 Merit-Based Incentive Payment System (MIPS) than last year.

That’s good.

However, you’re not certain if you’re one of those exempt physicians.

That’s bad.

If you’re required to participate in MIPS, your practice could be hit with a 5-percent Medicare pay cut in 2020, based on your 2018 performance.

That’s bad.

But you could receive a bonus payment in 2020 instead.

That’s good.

To get to the bottom of all of this, start by logging on to the updated MIPS Participation Lookup Tool to check your status under the Medicare Quality Payment Program (QPP). All you’ll need is your National Provider Identifier, or NPI. Now you’ll know if you are exempt.

Not exempt? Then start taking the steps necessary to receive a bonus in 2020 instead of a pay cut.

What steps are those? Well, check this out to get a better understanding of the 2018 QPP requirements:   

  • For a general overview of the QPP, explore the CMS QPP website. However, that website is not expected to be updated with 2018 information until this summer at the earliest, according to the American Medical Association. Meanwhile, the 2018 resources webpage is up to date.
  • For comprehensive, free education on how to navigate the 2018 QPP, visit the MACRA QPP Resource Center, which the Physicians Advocacy Institute developed with TMA input. 
  • To communicate with QPP experts via telephone, live chat, email, or a web-based platform, join the QPP Learning and Action Network by the TMF Health Quality Institute. TMF offers no-cost technical assistance and education for solo physicians and group practices of all sizes.
  • For customized on-site assistance to help you with your practice’s specific needs, TMA Practice Consulting offers personalized quality improvement services and a MACRA readiness assessment to help you succeed in the 2018 QPP.   

And after all that, if you still have questions, contact the CMS QPP Service Center at (866) 288-8292, or by email at QPP[at]cms[dot]hhs[dot]gov

As always, visit the TMA MACRA Resource Center to stay up to date on the latest information. 

Last Updated On

April 19, 2018

Originally Published On

April 19, 2018

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