MIPS Update, November 2018

On November 1, 2018, CMS released the final rule for year 3 of the Quality Payment Program.  As earlier proposed, all MIPS categories have the same performance period as 2018.   Additionally, clinicians will need to exclusively use 2015 CEHRT (V11) for the 90-day reporting period of the Promoting Interoperability Category.  CMS has also increased the performance threshold to 30 points and adjusted the maximum negative payment adjustment to -7% for not participating.

Here is a list of key items in the final rule:

  • Minimum reporting requirement has been increased to 30 points
  • Possible payment adjustment for not meeting the above is -7% or +7% for earning more than 30 points across all categories
  • 75 points must be earned to be considered for exceptional performance bonus
  • All categories have the same performance periods as Year 2 (2018)
  • Quality is now considered for 45% of the final score and CMS is allowing providers to use multiple collection types for this category
  • Cost accounts for 15% of final score
  • IA remains the same at 15%
  • PI (formerly ACI) still accounts for 25% of the final score.  Providers MUST use 2015 CEHRT for this category, but only for 90 days.

Click here to review the final ruling overview