APMA News - January/February 2018 - 46

IT Consultant
By James R. Christina, DPM, and
Dyane Tower, DPM, MPH, MS

MIPS in 2018: What's New?
A new year equals a new set of guidelines for the CMS Quality Payment Program (QPP). This article brieﬂy highlights some
important changes to the Merit-based Incentive Payment System (MIPS) for 2018.

Changes to Thresholds for Participation
In 2018, a provider is excluded from MIPS participation if
he or she has $90,000 or less in allowed Part B Medicare Fee for
Service charges or if he or she sees 200 or fewer Medicare Part
B Fee for Service beneficiaries. It is anticipated that once again,
CMS will have a look-up tool that allows you to enter your NPI
number to determine whether you are included in MIPS for
each of the NPI/TIN combinations under which you bill.

Cost is a new category for
2018, and it is automatically
calculated by CMS.

Reporting Periods in 2018

* Quality: 365 days
* ACI: 90 days
* IA: 90 days
* Cost: 365 days

Reporting Options

* Individual
* Group
* Virtual Group (new): Solo practitioners and groups of

10 or fewer doctors can come together to form a virtual
group (they must have elected to do this by December
31, 2017)

Additional Points for Small Groups
Five MIPS points will be added to the final score of any EP or
group in a small practice (15 or fewer clinicians). To earn these
five additional points, the EP or group must submit data in at
least one performance category (Quality, ACI, IA).

Change in Categories and Weighting

EHR Requirements

For 2018, CMS will use four categories to determine your
MIPS composite score:
Quality represents 50 percent of your total MIPS score
Advancing Care Information (ACI) represents 25 percent
of your total MIPS score
Improvement Activities (IA) represents 15 percent of
your total MIPS score
Cost represents 10 percent of your total MIPS score

In 2018, providers may use EHRs certified to 2014 or 2015
ONC standards.

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*
*
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In 2018, there is an ACI exception for practices with 15 or
fewer eligible providers (EP). You will be able to apply for the
exception, and your MIPS composite score will then be calculated based on the remaining three categories, with Quality representing 75 percent (IA and Cost weighting remain the same).
Cost is a new category for 2018, and it is automatically calculated by CMS. Cost will be calculated by Medicare spending
per beneficiary (MSPB) and total per capita cost measures.

Registry Reporting
The APMA Registry has been approved as a Qualified Clinical Data Registry for 2018. APMA is working on methods for
members to submit Quality data to the registry even if their
EHR vendor has not integrated with the APMA Registry, or if the
APMA members do not use an EHR. We will keep members
posted on progress.

Special Exemptions for Natural Disasters
Podiatrists in states affected by natural disasters should
check to see if they qualify for an exemption and if they need
to file any requests for 2018.
For more information on this topic, listen to the "MACRA Made
Easy: MIPS Year 2 Final Rule" webinar at www.apma.org/Events/
calendareventDetail.cfm?EventID=87685.
n

New Threshold to Avoid Penalty
You must earn a MIPS composite score of 15 points to avoid
the penalty of up to 5 percent that will be assessed in 2020.
46 APMA News January/February 2018

Contact Dr. Christina at jrchristina@apma.org, and
contact Dr. Tower at detower@apma.org.

http://www.apma.org/Events/calendareventDetail.cfm?EventID=87685 http://www.apma.org/Events/calendareventDetail.cfm?EventID=87685

Table of Contents for the Digital Edition of APMA News - January/February 2018