September 2017
Feedback requested: Federal CMS requests examples of burdensome certification/recertification requirements

The Centers for Medicare and Medicaid Services has requested help from the American Medical Association in identifying opportunities to reduce the administrative burden caused by certification requirements. In addition, the AMA has heard from some specialty societies about concerns with the development of local coverage decisions. In their discussions with the agency, they appear open to hearing about this issue as well. To that end, the AMA asks Colorado physicians and practice staff to provide feedback on the following:
 
CMS Administrative Relief: The AMA asks you to identify specific examples of certification requirements/forms that are adding burden to a physician practice, especially those that seem unnecessary.
 
LCD Process: The AMA asks you to identify any broad issues and concerns that they can then take back to the federal CMS. As an example, the AMA has heard that many specialties would like to be notified before publication of new or revised LCDs that affect their members.
                                                                              
Please send your feedback to Terri Marchiori ( terri.marchiori@ama-assn.org) with your feedback by Friday, Sept. 29. Email Jason Scull ( jason.scull@ama-assn.org) with any questions or concerns.
Oct. 2: Last call for improvement activities

Oct. 2nd is the deadline to start participating in MIPS to avoid a penalty in 2019. To attest to completion of an Improvement Activity(ies), clinicians must start implementing the activity no later than Oct. 2 to allow for the minimum 90 days of implementation. This means that if you haven't done so already, it is important to decide now which activity you will implement and determine how to gather the required documentation you will keep for six years in the event of an audit.
 
A guide from the federal CMS, " MIPS Data Validation Criteria," will walk you through the supporting documentation requirements. Use the spreadsheet to find documentation examples for each activity.
And review the activity's description in full detail to ensure there's enough time to implement (for example, annual registration in the prescription drug monitoring program requires six months).
Upcoming QPP-SURS webinar: MIPS calculator demonstration, Sept. 28

Do you know how the federal CMS calculates final MIPS scores? Or where scores are publicly reported for prospective patients and peers to see?
 
Get a better understanding of the components that factor into your MIPS final score by participating in a Telligen webinar at 11 a.m. on Sept. 28; speaker Kaitlin Nolte from Great Plains QIN-QIO will introduce a new calculator for estimating the financial impact of your final MIPS score. Advisers from Telligen will also provide example scenarios for different practices sizes. Click here to register.  
TMF Health Quality Institute provides support for small medical practices in CMS Quality Payment Program

Looking for help with the Quality Payment Program (QPP)? Not sure what MACRA or MIPS mean?
TMF Health Quality Institute, a leading nonprofit health care consulting company based in Austin, Texas, has been contracted by the Centers for Medicare and Medicaid Services to help transition eligible physicians and clinicians to the Merit-based Incentive Payment System (MIPS), one of two payment paths under the QPP.

TMF works specifically with physicians and clinicians in small practices with 15 or fewer clinicians -- including those in rural locations, health professional shortage areas and medically underserved areas -- to prepare for and participate in the QPP. TMF provides free technical assistance and support for practices in a region comprising Arkansas, Colorado, Kansas, Louisiana, Mississippi, Missouri, Oklahoma, Puerto Rico and Texas.
 
Free technical assistance is available immediately for all MIPS-eligible clinicians:
Visit tmf.org/QPP for more information about QPP and how to access educational resources and technical assistance.
Anthem Fall 2017 Provider Seminars starting next week

Anthem Blue Cross and Blue Shield will begin their fall provider seminars next week during which they will discuss useful information that can help physicians better navigate doing business with them. Sessions will cover the following topics:
  • Product overview for 2018
  • Mountain Enhanced network expansion
  • Affordable Care Act updates for 2018
  • CU Exclusive updates
  • Expansion of Electronic Member ID cards
  • ProviderAccess shut down timeline (Dec 2017)
  • Availity Web Portal enhancements
They will offer in-person meetings at different locations throughout the state, as well as online webinar options. To see all "in-person" and "webinar" dates, times and locations, view the Provider Seminar Invitation.
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Take Credit Cards? Is Your Practice Ready for the Oct. 15 EMV Deadline?

Important! What your practice needs to know about switching to EMV: Click here.
 


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Aetna - September 2017
 


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