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CMS Finalizes MIPS Reporting Year Regulations

The Centers for Medicare and Medicaid Services (CMS) released the final rule for the 2018 reporting year.


The final rule for the 2018 Medicare Quality Payment Program (QPP) MIPS reporting year/2020 payment year was released on November 2nd, 2017. The QPP was created under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Among other things, MACRA repealed the Sustainable Growth Rate Formula (SGR) for determining annual updates to Medicare Part B payment and replaced it with the new QPP. The QPP includes the following two participation options:

I) Merit-based Incentive Payment System (MIPS)

It is expected that initially, most Eligible Clinicians (Physicians, Physicians Assistants and Nurse Practitioners, Clinical Nurse Specialists and Certified Registered Nurse Anesthetists) will participate in the Merit-based Incentive Payment System (MIPS) which consolidates the existing Medicare value-based payment programs into a single program.

II) Advanced Alternative Payment Models (Advanced APM)

MIPS assess performance across four categories:

  • Quality
  • Cost
  • Use of technology
  • Practice improvement activities

Eligible Clinicians (ECs) opting to participate in MIPS can earn a positive or negative payment adjustment based on their total performance. For more detailed information regarding the 2018 MIPS reporting year: Washington Report, Federal Register.

Our MIPS reporting partner MIPSPRO makes the reporting process easy. Get started today to ensure your success and maximize your reimbursement!
Click Here to learn more or Get Started today!
posted by OBarros
posted in CMS Announcement,Healthcare Management,Healthcare Quality Reporting,Medical Billing,Medicare
posted date Dec 2017