The Centers for Medicare and Medicaid Services (CMS) announced updates relevant to final scores for the 2020 performance year, resulting in changes to bonus payment adjustments applied in 2022.  CMS identified two calculation errors related to bonus points for those in Medicare Shared Savings Program (MSSP) ACO’s and who submitted patient-reported outcome measures.  As a result, impacted participants will see higher scores and more providers now qualify for the ‘exceptional performer’ increase to positive payment adjustments.  Due to the budget neutral nature of the program, this also means that others will see a decrease in the original payment adjustment released earlier this year.

The highest positive payment adjustment awarded with the initial release of 2020 scores was 2.20% for a score of 100 pts.  After redistributing payment adjustments based on corrections, the highest positive payment adjustment is now 1.87% for a 2020 score of 100 pts.

In addition to the scoring corrections, CMS has announced that they are accepting requests to retroactively reweight 2020 scores based on the Extreme and Uncontrollable Circumstances policies for COVID-19.  CMS anticipates certain groups, who did not previously apply for the 2020 performance year, will be granted an updated neutral payment adjustment instead of a penalty with this flexibility. This may result in further recalculation of payment adjustments as CMS processes these requests.

The deadline to submit a Targeted Review of final 2020 MIPs scores has been extended to November 29th, 2021.  Participants that would like to request a review may apply through the Quality Payment Program website:

Please note that requests to reweight 2020 final scores under the EUC policy need to be submitted through the Targeted Review application due to the open application window for 2021 EUC requests.

To read the CMS announcement, CLICK HERE.

For more details on submitting a Targeted Review, CLICK HERE.

As always, ADVOCATE will continue to keep you informed on the issues impacting medical groups as they develop.

Kayley Jaquet

Manager, Regulatory Affairs