Update on MIPS Adjustment Error: CMS Correcting Issue, No Provider Action Required

March 6, 2019

In late January, ASCO notified members that some oncology practices and providers in the Merit-Based Incentive Payment System (MIPS) received inaccurate 2019 payment adjustments as a result of Medicare Part B drug costs incorrectly being included in the adjustments. CMS is now working to correct the payments. ASCO is in contact with the agency and will keep members informed as a solution is implemented. No action is required from MIPS participants at this time.

CMS recently published a fact sheet outlining 2019 MIPS payment adjustments, which are based on 2017 MIPS Scores, that explains program definitions, scoring, and other important aspects of the payments made to providers. The fact sheet includes explanations of how payment adjustment factors are applied, and how the resulting payments are made for physicians who participated in MIPS in 2017.

The fact sheet is also clear about Part B drugs not being included in 2019 MIPS adjustments, stating that “The payment adjustment will not apply to Medicare Part B drugs or other items and services that are not covered professional services. … Payments for these services furnished in 2019 by a MIPS eligible clinician are adjusted based on the clinician’s 2017 MIPS score.”

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