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Quality Payment Program (QPP) Support Center

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2018 Quality Payment Program Modifications Released

3/2/2018

The Bipartisan Budget Act of 2018 enacted by Congress and President Trump on February 9, 2018 extends the transition years for MIPS to include 2019, 2020 and 2021.
This goes beyond the 2017 and 2018 transition years the Centers for Medicare & Medicaid Services (CMS) allocated per the original Medicare Access and CHIP Reauthorization Act (MACRA) legislation. Additionally, the cost category does not need to be weighted to 30 percent until 2022, rather than 2019. 

The dollar amount and patient count thresholds for exclusion remain $90,000 and 200 patients, as proposed, but the low volume exclusion for MIPS will only be based on covered professional services. The payment adjustment percentage in 2018 will also be applied only to Medicare Part B covered professional services.

The penalty for non-participation without a MIPS exclusion will be 5 percent in 2018. The performance threshold will also increase annually and has been set at 15 points in 2018. CMS predicts that 74 percent of eligible clinicians will have MIPS scores above 70 in 2018. More than half a million clinicians' will have their 2017 MIPS scores publicly reported in late 2018.