The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) modernized how doctors are paid for their Medicare patients, increased efficiency, and reduced the cost for taxpayers. As part of MACRA, the Merit-Based Incentive Payment System (MIPS) was put in place. MIPS assess Medicare doctors and clinicians to give them a score, determining how much compensation the practice will receive from the government. Each year, there are modifications made that organizations must be aware of when filing their paperwork, as such we examine the 4 changes to keep in mind for your HIPAA MACRA MIPS 2019 filing.  

  • Exemptions for Extreme and Uncontrollable Circumstances (MACRA)

The Center for Medicare and Medicaid Services (CMS) has created an automatic exemption for the 2017 performance period for practices who were subject to natural disasters. CMS understands that there are extreme circumstances that may affect a practice’s ability to store and maintain records. Areas such as California, that had large-scale wildfires, and Houston’s extreme flooding, cannot be expected to have records. 

  • Cost Category Weighting Raised from 0 to 10 Percent (MACRA)

In 2018, CMS set the cost category weighting at “0,” however they have reevaluated and made the determination that the cost category weighting should be at “10.” A reduction of the quality category, offsets the cost category weighting for your total MIPS score. 

  • Low-Volume Thresholds Expanded (MACRA)

Practices that are MIPS-eligible, with $90,000 or less in part B allowed charges, or 200 or less part B beneficiaries, are exempt from MIPS requirements. In 2017, the threshold for exclusions was lower at $30,000 or 100 part B beneficiaries. This is important to note as practices that were subject to MIPS in previous years, may not be for HIPAA MACRA MIPS 2019.

  • Increase in MIPS’s Cost Category (MIPS)

An increase from 10% to 15% for the weight of MIPS cost category is suggested by CMS for 2019. To counterbalance this change, CMS decreased the weight for the quality category from 50% to 45%. 

When completing your HIPAA MACRA MIPS 2019 filing, organizations must look to the changes CMS has put forward. Although you may not have been exempt in previous years, you may be for 2019. 

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