Disqualify a Patient from MIPS Submission

*Denotes new criteria for 2022 Performance Year

Patients will be automatically removed from the MIPS registry if they:

    • Are under the age of 18 years old (or under 14 years old for the DHI*)
    • The patient has <2 visits for the related EOC (DHI only)*
    • Are not under treatment related to one of the 6 CMS-approved measures (LEFS, MDQ, NDI, KOS, DASH, DHI*) as indicated by the classification of Other
    • Does not complete 2 or more forms for an assigned measure (LEFS, MDQ, NDI, KOS, DASH) 
    • For the 2021 Performance Year: Patients with an Initial Evaluation on or after 12/15/2021
  • Please note that this does not set the "Disqualified" toggle in the patient Episode of Care. The patient will be excluded from MIPS reporting registry only if they fall under the above criteria. 

Patients can be manually disqualified from MIPS if they:

Keet Outcomes QCDR Measures (IROMS/KEET01):

    • Are non-English speaking and translation services are unavailable
    • Unable to accurately complete the MIPS PRO due to a mental or cognitive impairment
    • Meet medicare requirements for maintenance therapy, such as the maintenance of functional status or prevention of slow deterioration in function, as defined by the Medicare Benefits Policy Manual, Chapter 15
    • Are determined to be extremely medical complex and likely to make poor clinical progress based on the experience and clinical judgment of the treating clinician  
    • Ongoing care is not indicated, patient seen only 1-2 visits*
    • For the 2021 Performance Year: Patients with an Initial Evaluation prior to 12/15/2021 that are continuing care into 2022

DHI* (HM7):

    • Received hospice services at any time during the performance period*
    • Are unable to complete a DHI or equivalent instrument at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility without the availability of an adequate proxy available.*


For additional information on how to qualify/disqualify a patient review the following article: 

Qualifying a Patient for MIPS