CMS Releases Final Rule For MIPS 2019

Posted by AVS Medical on Fri, Nov 16, 2018

CMS has just released the final rule for MIPS in 2019 - Here’s what Practice Partner, Medisoft Clinical and Lytec MD users need to know!


MORE MIPS ELIGIBLE CLINICIANS


CMS has added the following types of providers as MIPS eligible providers In addition to MD/DO/DPM/DC/PA/NP

 
  • Clinical Psychologists
  • Physical Therapists
  • Qualified Audiologists
  • Occupational Therapists
  • Qualified Speech Language Pathologists
  • Registered Dietitian or nutritional professionals


HIGHER PAYMENT ADJUSTMENTS


  • Payment Adjustment Range from a -7% up to a +7% !


MORE LOW VOLUME EXCLUSIONS

In 2019 CMS has added a 3rd parameter to qualify for a low volume exclusion. In order to be excluded from MIPS in 2019 a Practice Partner, Medisoft Clinical or Lytec MD user would have to meet one of the following criteria:

  • Bill less than $90,000 in Part B covered professional services OR
  • Care for less than 200 beneficiaries OR
  • Deliver less than 200 covered professional services under the 2019 PFS (physician fee schedule) - This is the new low volume exclusion for 2019

PERFORMANCE CATEGORY WEIGHTS MODIFIED

MIPS2019
 
  • Quality category reduced from 50% of your MIPS score to 45%
  • Cost category increased to 15%
  • Promoting Interoperability (used to be known as Advancing Care) is 25%
  • Practice Improvement Activity is 15%

CHANGES TO THE QUALITY MEASURES

  • 8 new Quality measures were added - New
  • 26 measures were deleted - New
  • A list of measures can be found here
  • You’ll still report on a total of 6 measures
  • One measure had to be an Outcome or High Priority measure
  • You’ll report Quality data for the entire 12 month period
  • Report on at least 60% of the eligible cases for the 12 months

CHANGES TO PROMOTING INTEROPERABILITY

  • Your EHR must be a 2015 Edition Certified Electronic Health Record Technology (CEHRT)
  • Minimum 90 day reporting period - same as last year
  • The Base and Performance are replaced by a new single scoring methodology for Performance only
  • 4 objectives that must be met:
    • ePrescribing
    • Health Information Exchange
    • Provider to Patient Exchange
    • Public Health and Clinical Data Exchange
  • Two new measures have been added for ePrescribing
    • Query for Prescription Drug Monitoring Program (PDMP)
    • Verify Opioid Treatment Agreement as optional
  • Security Risk Analysis is required but without points

NEW!  - MIPS OPT IN POLICY

A new option has been added for MIPS 2019- the ability for a provider to “opt-in”.

  • Providers who meet 1 or 2 but not all 3 criteria can choose to opt-in to MIPS 2019
  • Can earn the same positive (or negative) payment adjustment
  • Allows them to prepare for future required MIPS participation

HELP FOR SMALL PRACTICES

  • Practices with 15 or fewer providers will receive a practice bonus
  • Included as part of the Quality score instead of stand alone
  • Bonus is increased by 6 points

To read the entire Final Rule for 2019 click here


To read the CMS Executive Summary of the final rule click here


2019 brings new challenges and changes for Practice Partner, Medisoft Clinical and Lytec MD EHR users. There are new and different requirements requiring changes to your software, and your workflow. Most importantly the bonus payment and or penalty payments have increased substantially.


During the course of the year AVS Medical will continue to provide you with timely and informative information on how you can best use Practice Partner, Medisoft Clinical and Lytec MD to succeed with MIPS in 2019

 

 

Interested in AVS Medical MIPS Consulting?

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Topics: MIPS Consulting, MACRA/MIPS, MIPS 2019, mips