CMS Announces Plans to Eliminate MIPS Penalties

September 9, 2016
Policy Snapshot
Centers for Medicare and Medicaid (CMS), Payment, Practice Management, Meaningful Use, Physician Quality Reporting System (PQRS)

On Thursday, September 8, Andrew Slavitt, Acting Administrator of the Centers for Medicare & Medicaid Services (CMS), announced in a blog posting that the agency heard concerns expressed by the American Medical Association and other physician organizations about the proposed start date for performance reporting by physicians under the new payment systems created by the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA. In a draft regulation issued last April, CMS proposed to require physicians to begin reporting under the Merit-based Incentive Payment System (MIPS) or through the advanced alternative payment model (APM) option on January 1, 2017, even though final regulations promulgating MACRA’s sweeping payment system changes would not be issued until the fall. On September 8, CMS announced that the final MACRA regulation will exempt physicians from any risk of penalties if they choose one of three distinct MIPS reporting options in 2017, in addition to the option of participating in an advanced alternative payment model (APM):

  • Full-year reporting that begins on January 1;
  • Partial year reporting for a reduced number of days; and
  • A “test” option under which physicians can report minimal amounts of data.

Physicians who report in 2017 may be eligible for bonus payments in 2019, depending on which option they choose. Those who opt for full-year reporting will be eligible to receive a “modest positive payment adjustment;” those who choose partial year reporting will be eligible for a “small positive payment adjustment.” Physicians who choose the “test” option will not be subject to any payment adjustments. Qualified participants in advanced APMs will be eligible for 5 percent incentive payments in 2019.

The Society asked CMS for more flexibility in the program in a letter sent earlier this summer in response to the proposed regulations. “This is a welcome step that should allow post-acute and long-term care practitioners to become familiar with the program and not be penalized for caring for the nation’s seniors” said Alex Bardakh, MPP, Director of Policy and Advocacy for the Society. “It shows that CMS is willing to listen to concerns of the physician community and be flexible in its implementation of these new payment models,” he concluded. While this is an important step, final regulations will provide more detail about participation requirements. Final regulations are slated to be released later this fall.

Society members can learn more about proposed regulations under MACRA by listening to a pre-recorded webinar accessible here.