Docs left in the dark again about MIPS requirements

Doctors for the second year in a row have been left waiting to find out whether they will have to comply with a new quality payment system outlined in MACRA.

Although the CMS finalized a rule late last year to exempt more small providers from complying with MACRA, the agency still has yet to notify doctors whether they're expected to report under MACRA's Merit-based Incentive Payment System. Physicians who haven't received their formal notices have been left vulnerable; if they do nothing, the CMS can later determine they were on the hook to comply with MIPS. The CMS estimates that 934,000 providers will be exempt from MIPS reporting; that includes physician practices with less than $90,000 in Medicare revenue or fewer than 200 unique Medicare patients per year. Initially, only 134,000 providers were going to be excluded from the program, as the original threshold for exemption was $30,000 in Medicare revenue or fewer than 100 Medicare patients. Providers were in the same situation last year and ultimately did not receive notices until May. The stakes are even higher than last year, as providers must report a full year of quality data, versus just for 90 days in 2017. "Physicians do not have basic eligibility information to determine whether they are even included in the MIPS program," Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association, said in a letter to CMS Administrator Seema Verma. "For medical group practices that manage reporting for dozens or even hundreds of clinicians under the program, this information is vital to the complex clinical and administrative coordination necessary to participate in MIPS," Gilberg said. A CMS spokesman said that the agency is committed to sharing the information with providers as soon as possible, but could not outline an exact timeline.