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  • MIPS Manual 2017—Financial Impact: How the Bonuses and Penalties Will Be Applied

    By Rebecca Hancock, Flora Lum, MD, Chris McDonagh, Cherie McNett, Jessica Peterson, MD, MPH, and Sue Vicchrilli, COT, OCS
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    This content was excerpted from EyeNet’s MIPS Manual 2017.

    You can opt to report and be scored as an individual or as part of a group. If you opt to be scored as an individual, CMS will use both your Tax Identification Number (TIN) and National Provider Identifier (NPI) to distinguish you as a unique MIPS participant. If you and your colleagues opt to be scored as a group, the group’s TIN will be used for your identifier.

    Payment adjustments are always applied at the TIN/NPI level. CMS will apply the payment adjustments at the TIN/NPI level, regardless of whether you received a final score as an individual or as part of a MIPS group.

    Your 2017 final score will follow you to a new TIN. Your 2017 final score will determine your 2019 payment adjustment, even if you move to a new practice after the 2017 performance year is over. When CMS applies your payment adjustment in 2019, it will look at the 2017 final score that was associated with your 2017 TIN, not the 2017 final score that is associated with your new practice’s TIN.

    CMS will start applying the MIPS payment adjustments in 2019. They will be applied throughout the year to each claim that you submit.

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    Next: The Alternative to MIPS: APMs in Brief

    Note: Meeting regulatory requirements is a complicated process involving continually changing rules and the application of judgment to factual situations. The Academy does not guarantee or warrant that regulators and public or private payers will agree with the Academy’s information or recommendations. The Academy shall not be liable to you or any other party to any extent whatsoever for errors in, or omissions from, any such information provided by the Academy, its employees, agents, or representatives.

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