Recently, the Centers for Medicare & Medicaid Services discovered an error in the implementation of the 2019 Merit-based Incentive Payment System (MIPS) payment adjustment – it incorrectly applies payments for Medicare Part B drugs and other non-physician services billed by physicians. Adjustments to impacted claims will occur in the near future:
a. If we overpaid a claim based on this error, you will get a notification for recoupment from your Medicare Administrative Contractor.
b. If we underpaid a claim, it will be adjusted.
c. You do not need to do anything.
As evidenced by the payment adjustments (positive or negative) seen in current ERAs the MIPS program represents real dollars for participating clinicians. The program continues in 2019 with the same Performance Measures – Quality; Promoting Interoperability; Improvement Activities; and, Cost Measures. To confirm individual provider’s eligibility for participation use the following link: https://qpp.cms.gov/participation-lookup Practices can choose to submit as a group or submit for each individual provider. And note, an individual may not be required to participate but if submitting as a group, that individual provider’s data is required to be included with the group’s data. More detail about group versus individual participation can be found at https://qpp.cms.gov/mips/individual-or-group-participation
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