CMS Ties COVID-19 Clinical Trial Data Reporting to MIPS

April 21, 2020
Clinicians who report this activity will automatically earn half of the total credit needed to earn a maximum score in the MIPS improvement activities performance category

Clinicians participating in the government’s Merit-based Incentive Payment System (MIPS) will be able to earn credit for participation in a clinical trial and reporting clinical information by attesting to the new COVID-19 Clinical Trials improvement activity, the Centers for Medicare & Medicaid Services (CMS) has announced.

In order to receive credit for the new MIPS COVID-19 Clinical Trials improvement activity, clinicians must attest that they participate in a COVID-19 clinical trial utilizing a drug or biological product to treat a patient with a COVID-19 infection and report their findings through a clinical data repository or clinical data registry for the duration of their study, according to the announcement.

In the current system, MIPS, a performance-based track of QPP that incentivizes quality and value, entails four performance categories that make up a clinician’s final score. Thee categories are Quality, Improvement Activities, Promoting Interoperability and Cost. 

The new improvement activity focused on COVID-19, CMS officials contend, provides flexibility in the type of clinical trial, which could include the traditional double-blind placebo-controlled trial to an adaptive or pragmatic design that flexes to workflow and clinical practice. It also carries a high weight from a scoring perspective.

Clinical trials could include ones conducted by the National Institute of Health (NIH). Clinicians could also report through a clinical data repository, such as Oracle’s COVID-19 Therapeutic Learning System. Oracle has developed and donated a system to the U.S. government that allows clinicians and patients at no cost to record the effectiveness of promising COVID-19 drug therapies, according to CMS officials.

Having clinicians use an open source data tool to submit their findings will bring the results of their research to the forefront of healthcare much faster, leading to improvements in care delivery and the ability to treat COVID-19 patients, they say.

Clinicians who report this activity will automatically earn half of the total credit needed to earn a maximum score in the MIPS improvement activities performance category, which counts as 15 percent of the MIPS final score, CMS stated. The Quality category (45 percent) is the highest weighted under MIPS, followed by Promoting Interoperability (25 percent) and then Improvement Activities and Cost, each at 15 percent.

CMS announced late last month that for clinicians reporting in MIPS and Medicare Shared Savings Program accountable care organizations (MSSP ACOs), the 2019 data submission deadline has been pushed back from March 31 to April 30.

What’s more, MIPS-eligible clinicians who have not submitted any MIPS data by April 30, 2020 will qualify for the automatic extreme and uncontrollable circumstances policy and will receive a neutral payment adjustment for the 2021 MIPS payment year, CMS said, adding that it’s still evaluating options for providing relief around participation and data submission for 2020.

“The best scientific and medical minds in the world are working night and day to find treatments to combat coronavirus,” said CMS Administrator Seema Verma. “But without solid data, their efforts are liable to run up against a brick wall… Today’s action encourages clinicians to report data that will help us monitor the spread of the virus, find innovative medical solutions, and unleash scientific discovery as we seek to overcome this terrible disease.”

Sponsored Recommendations

How Digital Co-Pilots for patients help navigate care journeys to lower costs, increase profits, and improve patient outcomes

Discover how digital care journey platforms act as 'co-pilots' for patients, improving outcomes and reducing costs, while boosting profitability and patient satisfaction in this...

5 Strategies to Enhance Population Health with the ACG System

Explore five key ACG System features designed to amplify your population health program. Learn how to apply insights for targeted, effective care, improve overall health outcomes...

A 4-step plan for denial prevention

Denial prevention is a top priority in today’s revenue cycle. It’s also one area where most organizations fall behind. The good news? The technology and tactics to prevent denials...

Healthcare Industry Predictions 2024 and Beyond

The next five years are all about mastering generative AI — is the healthcare industry ready?