CMS has issued its final 2019 rule for both the Physician Fee Schedule (PFS) and the Quality Payment Program (QPP), which includes the Merit-based Incentive Payment System (MIPS).
“Today’s rule finalizes dramatic improvements for clinicians and patients and reflects extensive input from the medical community,” CMS Administrator Seema Verma said in a statement. “Today’s rule offers immediate relief from onerous requirements that contribute to burnout in the medical profession and detract from patient care. It also delays even more significant changes to give clinicians the time they need for implementation and provides time for us to continue to work with the medical community on this effort.”
Under the final QPP rule, MIPS-eligible clinicians will be required to use a 2015 Edition certified EHR as of Jan. 1, 2019. CMS says this change is necessary so patients can more easily access their data and information can more easily be shared among doctors and other providers. But Ana Maria Lopez, MD, MACP, president of the American College of Physicians, has concerns, especially with the short implementation timeline. “Rushing implementation of these upgrades to meet a reporting deadline can have serious patient safety risks and is a major expense and burden, particularly to small practices,” Lopez said in a statement.
CMS also added an additional low-volume threshold exemption to MIPS for next year. To be excluded, providers or groups need to meet at least one of the following conditions:
• Have $90,000 or less in Medicare Part B allowed charges for covered professional services.
• Provide care to 200 or fewer Part B-enrolled patients.
• Provide 200 or fewer covered professional services under the PFS.
The minimum period for each performance category remains unchanged, so quality and cost stay at 12 months while improvement activities and promoting interoperability remain at a continuous 90-day period.
However, the weighting to the final score of the cost and quality categories have both changed. Cost increases from 10 percent to 15 percent of the total score, and quality drops from 50 percent to 45 percent.