The Medicare Access and CHIP Reauthorization Act (MACRA, Public Law 114-10) established the Merit-Based Incentive Payment System (MIPS) as a program under which your performance in two performance categories drives the application of an incentive or penalty. The payment adjustment is applied to payments 1 year after the completion of the performance period. For example, audiologists’ performance in 2020will determine the payment adjustment in 2022. CMS notifies Medicare providers of their payment adjustment in the fall prior to the application of the incentive or penalty. The payment adjustment increases over time and will be as high as 9% in 2022 based on 2020 performance. The payment adjustment is 7% in 2021 based on 2019 performance.
You must pursue a time-limited targeted review (appeals) process in order to overturn the incorrect application of the penalty. The process for requesting a targeted review of the 2021 payment adjustment (based on the 2019 performance period) will be announced in mid-2020.
The AQC offers a host of resources.
Resources are also available on the CMS website.