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Targeted Review of 2018 MIPS Scores Available

Participants in the Merit-based Incentive Payment System (MIPS) now can review their 2018 final scores and performance feedback. This final score determines the payment adjustment participants will receive in 2020.

MIPS-eligible clinicians or groups, including those subject to the alternative payment model (APM) scoring standard, may request that the Centers for Medicare & Medicaid Services (CMS) perform a targeted review of their performance feedback and final score. The deadline to submit a request is Sept. 30.

A targeted review may be beneficial if a participant recognizes:

  • errors or data quality issues for submitted measures and activities;
  • eligibility and special status issues (e.g., clinicians that fall below the low-volume threshold and should not have received a payment adjustment); and
  • erroneous exclusion from the APM participation list.

CMS encourages participants to contact the QPP for assistance in determining the need to submit a targeted review request. To request a targeted review, log into the QPP website with HCQIS Access Roles and Profile System credentials. The agency might request additional documentation.

If the targeted review request is approved, CMS will update the final score and payment adjustment as soon as possible. The agency will determine the amount of the upward payment adjustment after the targeted review submission period ends. Targeted review decisions are final and not eligible for further review.

America’s Essential Hospitals has established a resource page dedicated to the QPP. Visit this page regularly for new and updated information.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Emily Schweich is a senior communications associate for America's Essential Hospitals.

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