MIPS Participants: Check Payment Adjustments Carefully, Errors May be Present

January 31, 2019

ASCO has been informed that some oncology practices and providers in the Merit-Based Incentive Payment System (MIPS) have received inaccurate payment adjustments as a result of Medicare Part B drug costs incorrectly being included in the adjustments. The Centers for Medicare & Medicaid Services (CMS) is also aware of the error and is working to resolve the issue. ASCO is in contact with CMS and will continue to keep members informed as a solution is implemented.

Last year, Congress passed legislation that included an important correction to MIPS to ensure that payment adjustments under the program are not applied to Part B drug reimbursement. ASCO strongly advocated for this correction to ensure patient access to potentially life-saving cancer care under Part B.

This year is the first payment year for MIPS participants under the Quality Payment Program (QPP), which was established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Participants are strongly encouraged to review their reimbursement adjustments carefully. If you believe your adjustment is incorrect for any reason, please contact CMS’ QPP help desk at 1-866-288-8292 (TTY: 1-877-715-6222).

Additional questions may be emailed to macra@asco.org. Stay connected to ASCO in Action for updates on this issue and breaking cancer policy developments.