MEDICAID MU AND MIPS/MACRA – TWO SEPARATE PROGRAMS

Medicaid EHR Incentive Program/Meaningful Use and the Advancing Care Information Component of MIPS/MACRA – Two Separate Programs.

The Medicaid EHR Incentive Program (Meaningful Use/MU) is not the same as the Quality Payment Program (aka QPP, MIPS or MACRA). These are two separate programs, and eligible clinicians participating in each of them will need to individually attest to EACH program to meet the separate requirements. Currently there is no cross over of information from one program to the other. The MU program is active for Medicaid providers through program year 2021. The Advancing Care Information (ACI) performance category of MIPS (Quality Payment Program) begins in 2017 for determination of Medicare reimbursement rates in 2019. Although separate, ACI and MU are still quite similar. The objectives are nearly identical with the main difference in program scoring. By meeting MU requirements, Quality Payment Program participants will most likely attain a favorable, if not maximum, ACI performance category score. For Medicare providers, the goal should no longer be just meeting the MU thresholds; with the way the ACI performance category is scored, every numerator or point counts and could equate to an even larger increase in Medicare reimbursements. Not all Medicaid clinicians participate in Medicare and/or meet the eligibility requirements for participation in the Quality Payment Program. Please see the CMS Quality Payment Program website for eligibility information: www.QPP.CMS.gov.