05/05/2025    R. Alex Dellinger, DPM

MIPS Madness (Joseph Grillo, DPM)

Dr. Grillo, I definitely feel your pain. MIPS is
terrible and does nothing to enhance patient care.
Here is my opinion on a few things: (1) MIPS is
part of MACRA (the Medicare Access and CHIP
Reauthorization Act) and in 2015, it
OVERWHELMINGLY passed in congress: 92-8 in the
Senate. 392-37 in the House. So, it passed with
tremendous bipartisan support. (2) APMA did
everything it possibly could to prevent its
passage, as did almost every other medical
society. But it goes without saying, Congress
sometimes does things that makes us scratch our
heads. APMA continues to push for repeal of this
program. I personally contact my congressional
delegation each chance I can to tell them how bad
it is (you can too by contacting your senators and
representatives through their offices).

As far as MIPS goes, the APMA does a TREMENDOUS
job educating members about the program, and how
to mitigate its effect on us. They produce
multiple webinars each year on every category in
MIPS. They also educate members on how to obtain
"bonus money" through MIPS, as well as "only what
needs to be done just to avoid penalties".

There is no doubt, it's a complicated program, an
unnecessary program, and can leave your head
spinning. I will tell you that from the beginning,
up to this year, it has been quite easy to avoid
penalties. And even this year, if you are in a
small group (15 providers or fewer - you would
qualify!) your score is weighted 50:50 between
Improvement Activities and Quality measures. You
only have to attest to one single improvement
activity to get a perfect score in that category.
I won't explain the way to get there, but for
Quality, there is a way to report on only TWO
measures (via claims reporting). This involves
having to report a few extra codes when billing
E&M services to ONLY MEDICARE patients (not every
patient, like some other reporting).

If you are a member of APMA, the webinars
detailing all of this are available to you on
their website. The webinars on MIPS alone have
"saved" our group tens of thousands of dollars
that we would have "forfeited" to Medicare through
the penalties of MIPS (It's up to 9% now!).
I'm not speaking in any way for the APMA. I'm
speaking for myself, who is an APMA member and who
has benefitted greatly from their MIPS education.

R. Alex Dellinger, DPM, Little Rock, AR

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