Vol. 3 Ed.11 | October 22, 2020 |
|
QPP Participation Status Tool Includes Second Snapshot of 2020 Qualifying APM Participant and MIPS APMs Data
The Centers for Medicare & Medicaid Services (CMS) updated its Quality Payment Program (QPP) Participation Status Tool based on the second snapshot of data from Alternative Payment Model (APM) entities. The second snapshot includes data from Medicare Part B claims with dates of service between January 1, 2020 and June 30, 2020. The tool includes 2020 Qualifying APM Participant (QP) and Merit-based Incentive Payment System (MIPS) APM participation status.
How Do I Check My QP or APM Participation Status?
To view your QP or APM participation status at the individual level:
|
|
Virtual Group Election Period for MIPS 2021 Performance Year Now Open
If you are interested in forming a virtual group for the 2021 MIPS performance year, the election period has started. A virtual group must submit an election to CMS for each performance year that it intends to participate in MIPS as a virtual group (as required by statute). If your virtual group was approved for the 2020 MIPS performance year and intends to participate in MIPS as a virtual group for the 2021 MIPS performance year, your virtual group is still required to submit an election to CMS for the 2021 MIPS performance year between October 1, 2020 and December 31, 2020 (11:59 p.m. Eastern Time).
Download the 2021 Virtual Group Guide for further information regarding virtual group participation in MIPS, virtual group reporting requirements, the election process, checklists for virtual groups to consider, and sample templates.
|
|
Do You Know the Eight Exceptions to the Information Blocking Provision?
What is information blocking?
Information blocking is a practice by a health information technology (IT) developer of certified health IT, health information network, health information exchange, or health care provider that, except as required by law or specified by the Secretary of Health and Human Services (HHS) as a reasonable and necessary activity, is likely to interfere with access, exchange, or use of electronic health information (EHI).
Information Blocking and the QPP
To prevent actions that block the exchange of health information, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the QPP require MIPS-eligible clinicians (ECs) to show that they have not knowingly and willfully limited or restricted the compatibility or interoperability of their certified electronic health record (EHR) technology. MIPS ECs show that they are meeting this requirement by attesting to three statements about how they implement and use certified EHR technology (CEHRT). Together, these three statements are referred to as the “Prevention of Information Blocking Attestation.” If you are a MIPS EC who reports on the Promoting Interoperability performance category, you must attest to the Prevention of Information Blocking Attestation.
More Information:
Source: ONC. Information Blocking. Exceptions to the Information Blocking Provision.jpg. Available at https://www.healthit.gov/curesrule/final-rule-policy/information-blocking. Accessed on 10/19/2020.
|
|
Compare the Medicare Promoting Interoperability Program and MIPS Promoting Interoperability Performance Categories
CMS has made significant strides in relieving regulatory burdens for providers; supporting the patient-doctor relationship in healthcare; and promoting transparency, flexibility, and innovation in the delivery of care.
|
|
Updated APM Incentive Payment QP Public Notice File Available
CMS recently updated the QPP website to include 2020 APM Incentive Payment details. To access this information, clinicians and surrogates can log in to the QPP website using their HARP credentials.
Eligible clinicians who were Qualifying QPs based on their 2018 performance began receiving their 2020 5% APM Incentive Payments this month. For more information regarding eligibility, payments, and FAQs, please review the 2020 APM Incentive Payment Fact Sheet.
What Do I Need to Do in Order to Receive the APM Incentive Payment?
You do not need to do anything unless you have not yet received your payment and find your name on this public notice, which indicates that you will need to verify your Medicare billing information.
Note: If you do not verify your Medicare billing information by November 13, 2020, then CMS will not be able to issue your APM Incentive Payment.
|
|
Data Validation and Audit Results for QPP 2017 and 2018 Performance
Under the QPP, CMS conducts an annual data validation and audit (DVA) of MIPS measures and activities from the Quality, Improvement Activities, and Promoting Interoperability performance categories to ensure that the program is using accurate and useful data to validate measures and activities and inform future policy. MIPS participants chosen for this audit are randomly selected to include a representative sample of clinician types and submission methods.
MIPS clinicians selected for audit can contact the QPP for 2017 and 2018 DVA results at QPP@cms.hhs.gov or 1.866.288.8292, Monday through Friday, 8:00 a.m.–8:00 p.m. Eastern Time. Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.
Learn More
For information on the MIPS DVA process and requirements, please review the following resources found in the QPP Resource Library:
|
|
2020 Change Review Process Now Available for eCQM Users
The Change Review Process (CRP) provides electronic clinical quality measure (eCQM) users the opportunity to review and comment on draft changes to the eCQM specifications and supporting resources under consideration by the measure steward. This latest installment of the CRP for eligible professional/eligible clinician and eligible hospital/critical access hospital issues will be conducted using the web-based public comment tools on the Office of the National Coordinator (ONC) Project Tracking System eCQM Issue Tracker during fall 2020. Note that an ONC Project Tracking System account is required to post a question or comment. New users can create an account via the ONC Project Tracking System website.
CRP updates regarding issues available for public comment will be posted on the ONC Project Tracking System eCQM Issue Tracker summary page. To subscribe to weekly CRP digest emails containing updates on CRP activities, please email CRP@mathematica-mpr.com.
For More Information
To find out more about eCQMs, visit the Electronic Clinical Quality Improvement (eCQI) Resource Center. To report questions and comments regarding eCQMs, visit the eCQM Issue Tracker. To submit technical questions and issues related to the development and implementation of the Clinical Quality Language (CQL) standard, visit the CQL Issue Tracker.
|
|
Proposal to Allow APM Entities to Submit Extreme and Uncontrollable Circumstances Exception Applications
If the policy is finalized and an APM Entity’s application is approved, that APM Entity would receive a final score equal to the performance threshold for the 2020 MIPS performance year, and the MIPS-eligible clinicians in the APM Entity group would receive a neutral payment adjustment in 2022.
Who Is Eligible to Submit an Application?
- Medicare Shared Saving Program
- Next Generation ACO Model
- Vermont Medicare ACO Model
- Comprehensive Primary Care Plus (CPC+)
- Comprehensive ESRD Care (CEC)
- Bundled Payments for Care Improvement (BPCI)
- Oncology Care Model (OCM)
- Maryland Primary Care Program
- Independence at Home Demonstration
For More Information
|
|
QPP Key Deadlines and Reminders |
|
2020 Promoting Interoperability Hardship and Extreme and Uncontrollable Circumstances Exception Application Deadline: December 31
COVID-19 Flexibilities
The Coronavirus 2019 (COVID-19) pandemic has impacted all clinicians across the United States and its territories. However, CMS recognizes that not all practices have been impacted by COVID-19 to the same extent. For the 2020 performance year, CMS will be using its Extreme and Uncontrollable Circumstances policy to allow MIPS-eligible clinicians, groups, and virtual groups to submit an application requesting reweighting of one or more MIPS performance categories to 0% due to the current COVID-19 public health emergency. For more information, visit the QPP COVID-19 Response webpage.
For More Information
|
|
MIPS Performance Year (PY) 2020 Eligibility is anticipated to be finalized December 2020.
Fourth Snapshot for Full TIN APMs (Medicare Shared Savings Program) is December 31, 2020.
Submission Window Opens for PY 2020 January 4, 2021.
View the following resources to assist in planning for 2020 MIPS reporting:
|
|
Upcoming Webinars for Small Practices |
|
Maximizing Your Performance in the Promoting Interoperability Category for Solo and Small Group Practices
*Registration details will be announced later.
*Tuesday, December 8 at 3:30 p.m. ET
*Thursday, December 10 at 11:00 a.m. ET
|
|
QPP Frequently Asked Questions of the Month |
|
Question: What is a virtual group?
Answer: A virtual group has the flexibility to determine its own makeup. A solo practitioner or group can only participate in one virtual group during the performance year. They are comprised of 2 or more Tax Identification Numbers (TINs) consisting of the following:
- Solo practitioners who are MIPS-eligible (a solo practitioner is defined as the only clinician in a practice); and/or
- Groups that have 10 or fewer clinicians (at least one clinician within the group must be MIPS-eligible). A group is considered to be an entire single TIN.
Question: What are the advantages of participating in a virtual group?
Answer: Participating in MIPS as a virtual group may increase performance volume in order to be reliably measured; and provide an opportunity for members of a virtual group to collaborate, share resources, and potentially increase performance under MIPS.
|
|
New QPP Tools and Resources |
|
To prepare for the 2020–2021 performance year of the MIPS, CMS has posted new resources to the QPP Resource Library.
QPP Resources:
CAHPS® = Consumer Assessment of Healthcare Providers and Systems®. CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
|
|
CMS COVID-19 Stakeholder Calls
CMS COVID-19 Office Hour Calls (Tuesdays at 5–6 p.m. ET)
CMS has been hosting regular calls with a variety of clinicians, hospitals, other facilities, and states in an effort to keep stakeholders updated on their COVID-19 efforts. CMS understands that not everyone is available to attend the calls live, and is sharing access to recordings along with transcripts. CMS will continue to host calls and share information through their list serves and media. To keep up with the important work of the White House Coronavirus Task Force in response to COVID-19, visit https:/www.coronavirus.gov. For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.
|
|
COVID-19 Resources and Preparedness
In light of the COVID-19 pandemic, HSAG understands the priority to keep your patients and staff safe. Below are some resources to guide you.
CDC = Centers for Disease Control and Prevention
|
|
HSAG MIPS Participation Outreach
Each year, Health Services Advisory Group (HSAG) checks in with every eligible clinician and practice to ensure your plans for MIPS reporting are on track. You may receive phone calls, emails, and or fax communication from HSAG throughout the year. HSAG's goal is to ensure you are prepared to submit your best MIPS score. The team of QPP subject matter experts are excited to connect with you and learn more about your MIPS reporting plans this year. If your practice knows your MIPS reporting plans for 2020 now, click here to let HSAG know. By submitting your MIPS participation plans online, HSAG will not reach out via phone, and you can contact HSAG when you need to!
HSAG is 1 of 11 organizations awarded by CMS as a QPP Technical Assistance Support Contractor. Since 2017, HSAG has been your trusted resource, available to Medicare providers in Arizona, California, Hawaii, New Mexico, and the U.S. Virgin Islands. Also, in partnership with Alliant Quality, HSAG is Florida’s technical assistance contractor for the QPP. HSAG provides assistance on MIPS and Alternative Payment Models (APMs); two reporting paths under the QPP. Its services are provided at no cost to you.
|
|
November National Health Observances
|
|
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.
|
|
|
|
|
|
|
