2019 MIPS Requirements - What Docs Must do to Maximize their Revenues and Improve their Scores

Duration: 90 Minutes
Instructor: Stanley Nachimson
Webinar Id: 801628


One Attendee
Unlimited Attendees ?

The Training on Merit-Based Incentive Payment System (MIPS) - is the Medicare program which measures provider performance and increases or decreases provider fees based on the performance measuresm, We are entering the third year of the program with increased penalties and/or incentives which can greatly impact a provider’s reimbursements from Medicare.


The Merit-based Incentive Payment System was created in Medicare to measure the performance of physicians and others serving Medicare payments in several areas, and adjust payments to those providers based on how they score in the program.

Provides are measured in 4 areas - Quality of Services, Cost of Services, Practice Improvement Activities, and Promoting Interoperability. Each year, providers must submit data to CMS thru various sources. CMS then takes that data and computes scores.

Based on the provider score in relation to a threshold, the provider will either get (for 2019 scores) an increase of up to 7% in their Medicare Fee Schedule for top performers, a smaller increase or no increase for acceptable performance, and a decrease of up to 7% in their fee schedule for those providers below the threshold. Those changes are applied to the 2021 fee schedule.

Why should you Attend: Does a 7% increase in your Medicare reimbursements sound good to you? Does a 7% decrease in your Medicare fees sound bad to you? Either of these situations are possible for 2021 based on your performance in the 2019 MIPS program.

Medicare has issued new guidelines for this year, which impose specific requirements on doctors, physician assistants, CRNAs, physical therapists, occupational therapists, clinical psychologists, audiologists, speech language pathologists, and other providers who see Medicare patients.

Any of these provider types must understand their obligations in the MIPS program to avoid a penalty and perhaps earn incentive payments.

Areas Covered in the Session:

  • What is MIPS?
  • Who must Participate?
  • What Categories are Measured, and how?
  • What are the Quality Measures?
  • How is cost Determined?
  • What are Practice Improvement Activities?
  • How is data submitted?
  • How are Scores Calculated?
  • How are fee Schedule Adjustments made?
  • How can I improve my Chances of Getting a Positive Adjustment?

Who Will Benefit:
  • Providers Participating in Medicare

Speaker Profile
Stanley Nachimson is principal of Nachimson Advisors, a health IT consulting firm dedicated to finding innovative uses for health information technology and encouraging its adoption.

The firm serves a number of clients, including, the Cooperative Exchange, EHNAC, and InstaMed, Stanley is focusing on assisting health care providers, vendors, and plans with understanding the regulatory environment, assisting in implementation of regulation requirements, and providing advice on HIT industry status and trends. Stanley is the author of the authoritative paper on the cost of ICD-10 for physician practices, and is an active member of HIMSS, WEDI, and X12.

Stanley served for over 30 years in the US Department of Health and Human Services in a variety of statistical, management, and health technology positions. His last ten years prior to his 2007 retirement were spent in developing HIPAA policy, regulations, and implementation planning and monitoring, beginning CMS’s work on Personal Health Records, and serving as the CMS liaison with several industry organizations, including WEDI and HITSP. He brings a wealth of experience and information regarding the use of data, standards and technology in the health care industry.

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