Now Available: 2018 MIPS Performance Feedback and Final Score; MIPS Targeted Review; and 2020 MIPS Self-Nomination Materials

Now Available: 2018 MIPS Performance Feedback and Final Score

If you submitted 2018 Merit-based Incentive Payment System (MIPS) data, you can now view your performance feedback and MIPS final score on the Quality Payment Program website.

You can access your 2018 MIPS performance feedback and final score by:

  • Going to cms.gov/login
  • Logging in using your HCQIS Access Roles and Profile (HARP) system credentials; these are the same credentials that allowed you to submit your 2018 MIPS data

If you don’t have a HARP account, refer to the QPP Access User Guide and start the process now.

To learn more about performance feedback, you can view these frequently asked questions (FAQs). These FAQs highlight what performance feedback is, who receives the feedback, and how to access it on the Quality Payment Program website.

MIPS Eligible Clinicians Participating in MIPS Alternative Payment Model (APM) Entities

If you participated in one of the models below in 2018, your MIPS performance feedback is now available via the Quality Payment Program website:

  • Medicare Shared Savings Program Accountable Care Organization (ACO)
  • Next Generation ACO
  • Comprehensive Primary Care Plus
  • Oncology Care Model
  • Comprehensive ESRD Care

Under the MIPS APM Scoring Standard, the performance feedback will be based on the APM Entity score, and is applicable to all MIPS eligible clinicians within the APM Entity. This feedback and score does not have any impact on assessments performed by the specific model.

Individual clinicians and representatives of the APM Entity will be able to access performance feedback directly on the Quality Payment Program website using their HARP account.

New Access for Individual Clinicians

We’ve created a new QPP role that lets individual clinicians access MIPS performance feedback for all of their practices, virtual groups, and APM Entities. For more information please review the Connect as a Clinician document in the QPP Access User Guide.

Questions?

If you have questions about your performance feedback or MIPS final score, please contact the Quality Payment Program by:

Now Available: MIPS Targeted Review

If you participated in the Merit-based Incentive Payment System (MIPS) in 2018, your performance feedback, which includes your MIPS final score and payment adjustment factor(s), are now available for review on the Quality Payment Program website. The MIPS payment adjustment you will receive in 2020 is based on your final score. A positive, negative, or neutral payment adjustment will be applied to the Medicare paid amount for covered professional services furnished by a MIPS eligible clinician in 2020.

MIPS eligible clinicians, groups, and virtual groups (along with their designated support staff or authorized third-party intermediary), including APM participants, may request CMS to review the calculation of their 2020 MIPS payment adjustment factor(s) through a process called targeted review.

When to Request a Targeted Review

If you believe an error has been made in your 2020 MIPS payment adjustment factor(s) calculation, you can request a targeted review until September 30, 2019. The following are examples of circumstances in which you may wish to request a targeted review:

  • Errors or data quality issues for the measures and activities you submitted
  • Eligibility and special status issues (e.g., you fall below the low-volume threshold and should not have received a payment adjustment)
  • Being erroneously excluded from the APM participation list and not being scored under the APM scoring standard
  • Performance categories were not automatically reweighted even though you qualify for automatic reweighting due to extreme and uncontrollable circumstances

Note: This is not a comprehensive list of circumstances. CMS encourages you to submit a request form if you believe a targeted review of your MIPS payment adjustment factor (or additional MIPS payment adjustment factor, if applicable) is warranted.

How to Request a Targeted Review

You can access your MIPS final score and performance feedback and request a targeted review by:

  • Going to the Quality Payment Program website
  • 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. Please refer to the QPP Access Guide for additional details.

When evaluating a targeted review request, we may require documentation to support the request. If your targeted review request is approved, CMS may update your final score and/or associated payment adjustment (if applicable), as soon as technically feasible. Please note that targeted review decisions are final and not eligible for further review.

For more information about how to request a targeted review, please refer to the 2018 Targeted Review Fact Sheet and the 2018 Targeted Review FAQs.

Questions?

If you have questions about your performance feedback or MIPS final score, please contact the Quality Payment Program by:

2020 MIPS Self-Nomination Materials Now Available

Visit the Quality Payment Program Resource Library to Access 2020 Performance Period MIPS Self-Nomination Materials

This message is a reminder that the 2020 Performance Period MIPS Self-Nomination Materials are now posted on the Quality Payment Program Resource Library. Please click here to access the zip file of the 2020 Performance Period MIPS Self-Nomination Materials including the following:

  • 2020 Qualified Registry Fact Sheet
  • 2020 Qualified Clinical Data Registry (QCDR) Fact Sheet
  • 2020 Self-Nomination User Guide for QCDRs and Qualified Registries
  • 2020 Self-Nomination QCDR Measure Submission Template
  • 2020 QCDR Measure Development Handbook
  • QCDR Measure Development Workgroup Presentations

As a reminder, the 2020 Performance Period MIPS Self-Nomination Period will take place from 10 am ET July 1 to 8 pm ET September 3, 2019. Please note, the location of this zip file under the 2019 Resources Library is temporary. The updated location will be provided when available. For more information on these materials or to ask questions regarding the 2020 Performance Period Self-Nomination process, please contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292 (Monday-Friday 8AM-8PM ET). TTY users can call 1-877-715-6222.

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