CMS discontinues demo that waives MIPS requirements for clinicians

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The Centers for Medicare and Medicaid Services says low participation is to blame for its decision to nix a demonstration designed to test if exempting qualifying clinicians from Merit-Based Incentive Payment System requirements would change the way in which they deliver care.

The agency announced that “after careful consideration” it decided to discontinue the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration aimed at testing the concept of waiving MIPS requirements for clinicians who participate in certain MA plans that involve taking on risk.

“CMS will not be accepting applications for MAQI for 2019,” according to an announcement posted on its website.

The first performance period for the demonstration was in 2018, and it is slated to last for five years in total.

Clinicians who met the definition of a MIPS eligible clinician under the Quality Payment Program (QPP)—including physicians, physician assistants, nurse practitioners, clinical nurse specialists and certified registered nurse anesthetists—were eligible to participate in the MAQI demonstration. However, low rates of participation resulted in its discontinuation—at least for this stage, which is no longer active, according to CMS.

Also See: CMS Quality Payment Program exceeds first year participation goal

Participating clinicians had the opportunity to be exempt from MIPS reporting and payment consequences for a given year, according to the MAQI demonstration rules.

MIPS is a program for adjusting payments under the Medicare Physician Fee Schedule for eligible clinicians based on their performance in four performance categories: quality, cost, improvement activities and promoting interoperability.

When it launched the initiative last year, the agency wanted to see whether exemptions would increase participation in MA plans that are similar to Advanced Alternate Payment Models (APMs), and thereby accelerate the industry’s transition to value-based care.

Under the Quality Payment Program created by MACRA, clinicians participate in the QPP through one of two ways: MIPS, which adjusts Medicare payments based on combined performance on measures of quality, cost, improvement activities and advancing care information; or APMs, which require clinicians to take on risk for their patients’ healthcare spending.

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