CMS' quality payment program: 5 changes affecting anesthesia groups

CMS' 2020 Quality Payment Program Final Rule includes higher penalties, more risk for reporting providers and new reporting opportunities, according to Anesthesia Business Consultants President and CEO Tony Mira.

Five changes to note:

1. Under the Merit-Based Incentive Payment System, bonuses and penalties are now -9 percent to +9 percent of MIPS eligible clinicians relative to covered professional services in the 2022 payment year.

2. Providers reporting through MIPS must acquire 45 MIPS points in 2020, up from 30 MIPS points in 2019.

3. Providers and groups will still be permitted to voluntarily report quality metrics to CMS, but those interested in seeking a bonus will now be doing so at risk of penalty.

4. The reporting threshold for providers participating in MIPS has increased to 70 percent of all eligible cases, up from 60 percent in 2019.

5. Under the Qualified Registries under the Eligible Measure Applicability process, CMS implemented rules that require anesthesia providers to only report measures applicable to their particular practice.

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