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As reported in the July 10 issue of STATLINE, eligible pathologists who submitted 2017 Merit-based Incentive Payment System (MIPS) data through the Quality Payment Program website, can now view their performance feedback and MIPS final score. If you believe an error has been made in your 2019 MIPS payment adjustment calculation, you can request a targeted review from the Centers for Medicare & Medicaid Services (CMS) until October 1, 2018.

The following are examples of circumstances in which you may wish to request a targeted review:

  • Errors or data quality issues on the measures and activities you submitted
  • Eligibility issues (eg, you fall below the low-volume threshold and should not have received a payment adjustment)
  • Being erroneously excluded from the Alternative Payment Model (APM) participation list and not being scored under APM scoring standard
  • Not being automatically reweighted even though you qualify for automatic reweighting due to the 2017 extreme and uncontrollable circumstances policy

This is not a comprehensive list of circumstances. The CMS encourages you to submit a request form if you believe a targeted review of your MIPS payment adjustment (or additional MIPS payment adjustment) is warranted.

How to Request a Targeted Review

You can access your MIPS final score and performance feedback and request a targeted review by:

  • Going to the Quality Payment Program website
  • Logging in using your Enterprise Identity Management (EIDM) credentials; these are the same EIDM credentials that allowed you to submit your MIPS data. Please refer to the EIDM User Guide for additional details.

When evaluating a targeted review request, the CMS will require additional documentation to support the request. If your targeted review request is approved, the CMS will update your final score and associated payment adjustment (if applicable), as soon as technically feasible. The CMS will determine the amount of the upward payment adjustments after the conclusion of the targeted review submission period. Please note that targeted review decisions are final and not eligible for further review.

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On July 24, the CAP hosted a complimentary webinar where CAP experts reviewed the proposed 2019 Medicare Physician Fee Schedule and the QPP regulations changes that will impact payment for services and pathologists’ participation in MIPS. Donald S. Karcher, MD, FCAP, Emily E. Volk, MD, FCAP and W. Stephen Black-Schaffer MD, FCAP reviewed these proposed changes in depth and answered questions from participants.

The webinar recording will be available later this week on The CMS will finalize the 2019 Physician Fee Schedule and Quality Payment Program regulations during the fall of 2018.

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As an important partner in health care policy, the American Medical Association (AMA) and the CAP work together on issues to reduce regulatory burdens and influence legislation concerning patients and physicians. The AMA Council on Long Range Planning and Development would like CAP members to help identify and better understand important issues relevant to health care and the practice of medicine by taking this survey.

The AMA Council on Long Range Planning and Development studies and evaluates the long-range objectives and policy development process in order to make recommendations to the AMA Board of Trustees on the strategic issues related to AMA's vision, goals, and priorities. The last day to complete the survey is August 31.

If you have questions about the survey, contact Susan Close at

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Payment for pathology services has a direct impact on the success of your practice. Do you know who makes these decisions—and what criteria they use? Are there steps you can take to ensure fair compensation? These topics and more will be explored at CAP18.

Educational Sessions
  • MACRAscopic Analysis of the New Quality Payment Program: Maximize Reimbursement While Demonstrating Value (S1620)
  • How Is My Payment Determined for Pathology Services? (STA008) Non-CME course
  • Lunch Roundtables
    • Current Payment Policy Challenges in Pathology Practice (R1691)
    • My Surgical Pathology and Cytopathology Coding Dilemmas: Getting It Right—An Advanced Discussion (R1690)
Learning Pavilion Sessions
  • Understanding and Maximizing your MIPS Score
  • How to Keep Your Practice Afloat While Reimbursement Rates Decline
CAP Exhibit Booth

  • Pathologists Quality Registry Demos
  • MIPS Resources for Pathologists
  • Billing and Cost Assessment Toolkits

Check out the full list of Advocacy courses offered at CAP18.

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Navigating all the requirements related to successfully complying with MIPS can be confusing; especially for non-patient-facing physicians such as pathologists. And on top of that, you may be at risk for losing bonus opportunities if you don’t fully optimize your participation.

As part of our ongoing commitment to ensure pathologists are able to successfully participate in new and evolving payment models, the CAP is pleased to offer a comprehensive MIPS education webinar series specifically developed for pathologists, led by experts who will take a deep dive into components of the MIPS program. Upon completing the six webinars in this program, you will fully understand program requirements, be able to optimize your participation and successfully comply with MIPS.

Diana Cardona, MD, FCAP

The first in this webinar series – Maximize Your MIPS Bonus Potential – will take place on Thursday, August 9 at 12 PM ET/ 11 AM CT. During this 30-minute webinar, Diana Cardona, MD, FCAP, Chair of the Economic Affairs Measures & Performance Assessment Subcommittee, will review key elements of the MIPS program as it relates to understanding and maximize scoring, including selecting the right measures and improvement activities that have the maximum scoring and bonus point potential.

Attendees can submit their questions about MIPS points and scoring in advance when they register for the webinar.

Register to attend the first webinar now!

Look out for upcoming MIPS educational webinars in future editions of STATLINE.

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For the fourth consecutive year, the CAP's STATLINE earned an Award of Excellence for 2018 in APEX’s newsletters category. This was the 30th annual APEX Awards for Publication Excellence.

APEX awards are based on excellence in graphic design, editorial content, and the ability to achieve overall communications excellence. Moreover, APEX's Award of Excellence recognizes exceptional entries submitted in dozens of individual categories covering print and digital media. STATLINE also received APEX awards in 2015, 2016, and 2017.

For the 2018 APEX contest, STATLINE staff submitted news coverage of the 2017 annual Policy Meeting.

Since 1979, members of the College have read STATLINE as their official source for advocacy and policy news from Washington, DC. STATLINE provides its target audience of pathologists with news articles on topics ranging from federal regulation to legislation and local grassroots action. CAP members receive STATLINE electronic newsletter issues on a weekly basis.

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The CMS will host a 60-minute Physician Compare webinar on Thursday, July 26 at 3 PM ET about public reporting on Physician Compare and information in the pipeline for potential inclusion on Physician Compare in late 2018, including Year 1 Quality Payment Program performance information. Participants will have an opportunity to ask questions. The webinar will cover:

  • Overview of public reporting on Physician Compare
  • MIPS and APMs on Physician Compare
  • Upcoming 30-day Preview Period

Register today.

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