The QPP Quest
Volume 1 Ed. 12 | November 2018
View and Download Resources
Hot Off the Press!
CMS Releases Final Rule for the 2019 Quality Payment Program  
On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued its policies for Year 3 (2019) of the Quality Payment Program (QPP) via the Medicare Physician Fee Schedule (PFS)  Final Rule. The provisions in the rule build on the foundation established in the first two years of the program and are reflective of the feedback CMS received from many stakeholders. Take time to read the  Fact Sheet  today!

Extreme and Uncontrollable Circumstances Policy for MIPS Eligible Clinicians Affected by Hurricanes Florence and Michael
CMS understands that if you’re a clinician living or practicing in an area affected by Hurricane Florence and Hurricane Michael, you may experience difficulties collecting and submitting data on time during the 2018 MIPS performance period for the Merit-based Incentive Payment System (MIPS). Most recently, for those affected by Hurricane Florence , Hurricane Michael , and the California Wildfires , CMS tried to lessen eligible clinicians’ burden by not requiring a hardship application to reweight the performance categories under MIPS.
Please note: MIPS eligible clinicians in Advanced Payment Model (APM) entities who are subject to the APM scoring standard are not covered by the automatic extreme and uncontrollable circumstances policy.  
The Quality Payment Program Resource Library is Back on QPP.CMS.GOV!
CMS has moved its QPP resources from  CMS.gov  to the newly redesigned  Quality Payment Program Resource Library  on  qpp.cms.gov . Following feedback from clinicians and others in the healthcare community, CMS wanted to make QPP information and resources available in one place. They have also made it easier for you to find the resources you’re looking for by including a search function that allows you to search for resources by year, reporting track, performance category, and by document type (e.g., fact sheet, user guide, measure specifications).
Help CMS Improve the Quality Payment Program!

Interested in providing CMS feedback on the QPP website to continue improving the QPP experience? Email  CMSQPPFeedback@Ketchum.com to participate in a feedback session.
QPP Frequently Asked Question of the Month
Question: What are realistic goals for a very small practice? 

Answer: Small practices can be successful in the QPP. In 2018, you will need to earn 15 points to remain neutral. This can be done by submitting complete data in the Improvement Activities (IA) category. CMS offers a small practice bonus (in points) for submitting data in at least one category. If you do not have an electronic health record (EHR), consider submitting the Hardship Exception and focus on the Quality and IA categories.  
MIPS Top Tips of the Month
  1. Review the QPP Year 3 Final Rule Fact Sheet if you are a physical therapist, occupational therapist, speech-language pathologist, audiologist, clinical psychologist, registered dietitian or a nutrition professional. Call us at 844.472.4227 Monday-Friday 8 a.m.–8 p.m. ET to get started with the QPP.
  2. Practices planning to submit data to CMS in the Promoting Interoperability category only have 33 days to complete a Security Risk Analysis (SRA).
  3. Prepare for 2018 MIPS Data Submission by obtaining your Enterprise Identity Management (EIDM) account. Need an EIDM account? Click here.
Upcoming Learning Forum Friday Events
December 14, 2018
1 p.m. ET
Don’t Forget to Prepare to Submit
Join HSAG to learn how to:
  • Determine EIDM accounts are setup for submission.
  • Identify MIPS category requirements. 
  • Recognize how to submit data through the QPP Portal.
January 11, 2019
 1 p.m. ET
QPP Year 2—Data Submission Tips and Tricks
Join HSAG to learn how to:
  • Recognize how to submit MIPS data through the attestation portal.
  • Identify the various QPP submission methods.
  • Determine possible advantages and disadvantages of each submission method.
Did You Miss the November 9th Learning Forum Friday Webinar?

Download the webinar recording for Don’t Risk Being Unsecured . The presentation slides are also located at https://www.hsag.com/lff . Register for upcoming webinars and browse past webinars to prepare for your 2018 MIPS data submission!
Here's What Your Peers are Saying About Learning Forum Fridays:
  • I found helpful the supporting documentation in the event of an audit.
  • I liked the resources to follow-up and create a risk assessment.
  • The overview of the changes to the Promoting Interoperability category was the most valuable part.
Upcoming Webinars for Small Practices
Today! Thursday, November 29, 2018
3:30 p.m. ET
Overview of the 2019 Final Rule: Implications for Solo and Small Practices
Participants will learn:
  • Key changes in Year 3 of the MIPS program.
  • Practical tips for how small group practices can successfully respond to these adjustments.
  • How to access Free technical assistance resources available from CMS or a local Technical Assistance Organization funded by CMS.
Centers for Medicare & Medicaid Services (CMS) Updates
CMS has released 2017 performance data for the QPP. They  announced the preliminary data earlier this year and have now released additional data elements that show significant success and participation in both the MIPS and APM tracks. For a complete breakdown of the 2017 performance data, please see the CMS  blog  post and  2017 Quality Payment Program Performance Year Data Infographic .
QPP Participation Status Tool Now Includes Second Snapshot of 2018 Qualifying APM Participant and MIPS APMs Data
CMS updated its  Quality Payment Program Participation Status Tool  based on calculations from the second snapshot of Medicare Part B claims data to calculate the APM entities’ threshold scores. The second snapshot is for dates of participation between January 1 and June 30, 2018. As a reminder, the tool includes 2018 Qualifying APM Participant (QP) and MIPS APM status. CMS will release the third QP and MIPS APM status data based on snapshots of claims between January 1, 2018 and August 31, 2018.
 
To check your QP or MIPS APM Status:
Multi-Payer Other Payer Advanced APMs List
CMS published a list of payment arrangements with CMS Multi-Payer Models that CMS has determined to be Other Payer Advanced APMs for the Calendar Year (CY) 2019 QP Performance Period, based on submissions from payers made earlier this year through the Payer Initiated Process, and based on the Other Payer Advanced APM criteria in effect. The list is in the document on the QPP Resource Library under the title  2019 QPP Multi-Payer Other Payer Advanced APMs .
Medicare Learning Network (MLN) Updates
Wednesday, December 5, 2018
12 Noon–1 p.m. ET

IPPS Final Rule: Changes to the Medicare Promoting Interoperability Program Webinar 
During this webinar on the 2019 Inpatient Prospective Payment System (IPPS) final rule, CMS explains major changes to the Medicare Promoting Interoperability Program for 2019 and 2020, including:
  • 2019 and 2020 Electronic Health Record (EHR) reporting period
  • 2015 edition requirements for certified EHR technology
  • Performance-based scoring methodology
  • Objective/measure changes for 2019
Reducing Clinician Burden
CMS released a  letter  to clinicians outlining how the agency is reducing burden through reform of documentation and coding requirements. We encourage you to read and share with your stakeholders.  
QRURs and PQRS Feedback Reports: Access Ends December 31
The final performance period for the Value Modifier and Physician Quality Reporting System (PQRS) programs was 2016 and the final payment adjustment year is 2018. Quality and Resource Use Reports (QRURs) and PQRS Feedback Reports will no longer be available after the end of 2018. If you need these reports, download them through December 31, 2018, from the  CMS Enterprise Portal  using an EIDM system account with the correct role. Visit the  How to Obtain a QRUR  webpage for more information. 
Accredited Online Course—Continuing Education Credits
Quality Payment Program in 2018: Advanced APMs Web-Based Training Course is available through the  MLN LMS .

Learn about:
  • APMs, including how to identify an Advanced APM and a CMS Advanced APM.
  • How to participate in QPP via an Advanced APM.
New Medicare Card Mailing Update—Wave 6 Ends
CMS finished  mailing cards  to people with Medicare who live in Waves 1–5 and now Wave 6 states (Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Texas, Utah, Washington, and Wyoming). Card mailing in Wave 7 states and territories continues.
News and Networking
Calling Newly Eligible Clinician Types for QPP Year 3 (2019)!
Call HSAG’s QPP Service Center at 1.844.472.4227 to learn about the
Quality Payment Program or MIPS.
Quality Initiative Spotlight
Cardiac Health Spotlight

Join HSAG in Celebrating Our 2018 Hypertension Control Champions! 
 
View the list of 2018 Champions and stories from past champion Success Stories .
Immunization Health Spotlight
December 2–8 is  National Influenza Vaccination Week (NIVW). NIVW is a national awareness week focusing on the importance of influenza vaccinations. To learn more from the CDC, click here .  
Diabetes Health Spotlight
Help your diabetic patients start 2019 off right by inviting HSAG to educate them in diabetes self-management, in Spanish or English, at no cost!
Give HSAG a call to arrange for classes to be conducted onsite* in your practice and at your convenience :

  • Arizona: Padma Taggarse, MMI, MBA, HSAG Physician Office Quality Executive Director, at 602.614.8942 or ptaggarse@hsag.com.
  • Florida: Laura Gamba, CBA, BA, HSAG Director, at 813.865.3351 or lgamba@hsag.com.
  • Ohio: Bonnie Hollopeter, LPN, CPHQ, CPHIMS, HSAG Diabetes Care Task Lead, at 614.307.2036 or bhollopeter@hsag.com.

*Space is not an issue.
QPP Tools and Resources
Subscribe to Get the Information You Need
Subscribe to HSAG's QPP Quest Digest
Invite your practice staff, practices you refer patients to, and other colleagues to subscribe to HSAG’s QPP Quest Digest!   Stay informed of all monthly QPP updates, deadlines, no-cost webinars and best practices by subscribing  here .
CMS QPP Listserv
Don't forget to sign up on the  CMS.gov QPP website . Once you've accessed the QPP page, scroll to  [Subscribe to Updates]  at the bottom of the page and insert your email address before clicking  [Subscribe] . The QPP listserv is a valuable resource to stay informed of webinars and important QPP deadlines.
Health Services Advisory Group
This material was prepared by Health Services Advisory Group, the Medicare Quality Improvement Organization for Florida, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. FL-11SOW-D.1-11292018-01