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MIPS UPDATE – Final Rule for the 2022 Quality Payment Program (QPP) Released.

On Tuesday, November 2, 2021, the Centers for Medicare & Medicaid Services (CMS) released the Final Rule for the 2022 Quality Payment Program (QPP). Below is a summary of some of the 2022 Performance Year (PY) QPP Final Rule changes and updates:

  • Traditional Merit-Based Incentive Payment System (MIPS):
    • Performance Thresholds
      • 75 points to avoid a potential -9% penalty in 2024 on Medicare reimbursement
      • 89 points to qualify for the exceptional performer bonus
    • Quality Category
      • Decrease category weight from 40% to 30%
      • Remove end-to-end, high-priority measure, and extra outcome measure bonus points
      • Establish a 7-point floor for new measures in the first performance year and a 5-point floor in the second performance year
    • Cost Category
      • Increase category weight from 20% to 30%
      • Add five new episode-based cost measures, including a Colon and Rectal Resection measure
    • Promoting Interoperability Category
      • Keep category weight of 25%
      • Apply an automatic reweighting for small practices and clinical social workers
      • Add a new measure: “High-Priority Guide of the Safety Assurance Factors for EHR Resilience Guides (SAFER Guides)” with yes/no attestation, in which a no response does not affect the Public Interest (PI) score in 2022
      • Require eligible clinicians to report the two measures below, unless an exclusion can be claimed:
        • Immunization Registry Reporting
        • Electronic Case Reporting (eCR)
          • New exclusion added: Certified EHR Technology (CEHRT) not certified for eCR
    • Improvement Activities Category
      • Adding 7 / removing 6 / modifying 17 improvement activities
      • Suspend activities that raise possible safety concerns or become obsolete outside of the rulemaking process
  • Electronic Prescribing of Controlled Substances (EPCS) mandate delayed until January 1, 2023 for Part D patients (unless state mandate had required an earlier time frame)
  • Delaying MIPS Value Pathways (MVPs) until 2023
    • Seven MVPs finalized:
      • Advancing Rheumatology Patient Care
      • Coordinating Stroke Care to Promote Prevention and Cultivate Positive Outcomes
      • Advancing Care for Heart Disease
      • Optimizing Chronic Disease Management
      • Adopting Best Practices and Promoting Patient Safety within Emergency Medicine
      • Improving Care for Lower Extremity Joint Repair
      • Patient Safety and Support of Positive Experiences with Anesthesia
    • Submission of MVPs as a subgroup allowed

For more information, including an executive summary of the 2022 Final Rule, please visit qpp.cms.gov.

Other Educational Resources
Use the MIPS Guide 2021, available on modmed® Communities for Gastroenterology, to set up a MIPS Report using the MIPS Dashboard in gGastro®. The MIPS report allows users to view an individual provider or group MIPS score.

REMEMBER: To submit MIPS data for 2022, you will need gGastro version 5.0 or later. Click here for more information. 

Visit QPP and the 2022 Final Rule for additional information and resources about MIPS.

 

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