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Your 2017 MIPS Payment Adjustment May Have Changed Due to CMS' Recent Recalculations

CMS recently reissued the 2017 MIPS final scores after revising its scoring logic and recalculating the original results.  Based on concerns posed through the Targeted Review Process in which clinicians request a formal review of their results to confirm accuracy, CMS identified errors in the scoring formulas for three elements of the program:

• The Extreme and Uncontrollable Circumstances hardship exception of the Advancing Care Information category;
• Participation in the Burden Reduction Study activity in the Clinical Practice Improvement Activities category;
• The All-Cause Readmission measure

Upon correcting the respective scoring logic, CMS recalculated the scores of the impacted physicians which subsequently changed their bonus amounts.  In turn, because the program is budget neutral, other participants were expected see their payment adjustments modified as a result and, in fact, almost all of APS’ clients experienced a reduction in their bonus rates.  The revised performance feedback details were posted on September 13, 2018.

CMS has extended the deadline for the Targeted Review Process to October 15, 2018, 8:00 pm EST, to allow opportunity for clinicians and Alternative Payment Model entities more time to access and review their performance feedback reports.

You can review the full details of the issue in the CMS fact sheet located here.

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