File Your MIPS Targeted Review Request by Sept. 30
By David Doolittle

Cigna_Etip

Physicians have two weeks to file a targeted review request to appeal errors in their 2018 Merit-Based Incentive Payment System (MIPS) performance feedback and 2020 Medicare payment adjustment under the Quality Payment Program (QPP).

This deadline applies to physicians who participated in regular MIPS and MIPS alternative payment models (APMs). It also applies to physicians in advanced APMs who did not meet the Medicare thresholds and defaulted into regular MIPS or the APM scoring standard within MIPS.

Physicians should check their 2018 MIPS performance feedback and 2020 payment adjustment as soon as possible in case the Centers for Medicare & Medicaid Services (CMS) made mistakes when calculating your data, which happened last year.

A mistake would affect the amount of your Medicare bonus or pay cut next year, or worse, result in a cut when you should receive a bonus. And because MIPS scores also are reported annually on the Physician Compare website, you’ll want to ensure CMS got it right.

If you have not checked your final performance feedback and whether you’ll get a bonus or penalty next year, the Texas Medical Association recommends you do so now as the targeted review deadline is 7 pm (CT) Monday, Sept. 30.

You can access your MIPS final score and performance feedback by: 

  • Going to the QPP website, and
  • Logging in using your HCQIS Access Roles and Profile System (HARP) credentials. These are the same credentials that allowed you to submit your MIPS data. For complete information about this process, refer to the QPP Access User Guide (zip file). If you don’t have an account, register here

Filing a targeted review request means CMS will review your information again and make corrections accordingly. If you miss the Sept. 30 deadline, there will be no other way to file an appeal. Of note, the targeted review process is different from the regular appeals process for Medicare claims determinations. Requests must go through the process described in the following CMS documents: 2018 Targeted Review Fact Sheet and 2018 Targeted Review Frequently Asked Questions

If you have questions about your performance feedback or MIPS final score, or whether you should submit a targeted review request, contact the QPP Service Center at (866) 288-8292 or by email at QPP@cms.hhs.gov. You can also contact MIPS experts at the TMF Health Quality Institute for no-cost assistance.

And don’t forget, TMA offers in-person quality improvement services and tailored practice support to help you earn incentive payments, not just avoid penalties. Contact TMA Practice Consulting to learn more on how you can improve your scores moving forward.

As always, visit TMA’s MACRA Resource Center for a comprehensive array of QPP help.

Last Updated On

September 18, 2019

Related Content

MACRA | Medicare | Quality reporting

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.

More stories by David Doolittle