CMS Announces Revisions to Quality Payment Program

On May 20, 2021, CMS announced that the 2020 Merit-based Incentive Payment System (MIPS) Cost Performance Category under the Medicare Quality Payment Program (QPP) incentive program will be reweighted to 0% of the final score even if eligible physicians or groups submitted 2020 data in other MIPS categories in light of the impact of the COVID-19 pandemic. For more than a year, ISASS and other stakeholders, including the American Medical Association (AMA), have been recommending that CMS zero out this category during the pandemic for several reasons, including concerns that decreases in patient visits and increases in the costs of caring for patients with COVID-19 could unfairly penalize physicians. With this action, CMS will be holding physicians harmless from unfair evaluations in the MIPS Cost Performance Category as a result of the COVID-19 pandemic.

CMS also announced they will release the 2018 and 2019 cost measure benchmark files. ISASS has been urging CMS for a while to should publish the data. In April, several specialty societies sent a letter urging CMS to immediately release the MIPS cost benchmarks to increase transparency in how the agency evaluates physician performance in the Cost Performance Category in MIPS and to allow physicians and other stakeholders to assess the measures for validity and opportunities to reduce spending. We anticipate this information will be informative for specialty societies that are engaged in the ongoing development of new episode-based cost measures and MIPS Value Pathways.

To view the April letter, click here