Volume 2 Ed. 11 | November 21, 2019
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2020 Quality Payment Program Final Rule Released
Key finalized policies for 2020 include:
- Maintaining the weights of the Cost (15%) and Quality (45%) performance categories
- Increasing the performance threshold from 30 points to 45 points
- Increasing the data completeness threshold for the quality data that clinicians submit to 70%
- Increasing the Improvement Activity performance category participation threshold for group reporting from a single clinician to 50% of the clinicians in the practice
- Revising the specifications for the Total Per Capita Cost (TPCC) and Medicare Spending Per Beneficiary (MSPB) Clinician measures
- Updating requirements for Qualified Clinical Data Registry (QCDR) measures and the services that third-party intermediaries must provide (beginning with the 2021 performance period)
For More Information
- Press Release – Includes more details about the 2020 QPP Final Rule announcement
- Executive Summary – Provides a high-level summary of the 2020 QPP final rule policies
- Fact Sheet – Offers an overview of the QPP policies for 2020 and compares these policies to the 2019 requirements
- Frequently Asked Questions (FAQs) – Addresses frequently asked questions about 2020 QPP final rule policies
- MVPs Video – Provides an overview of the MVPs participation framework
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Hurricane Dorian and MIPS Reporting
Did you know due to Hurricane Dorian, you may qualify for an Extreme and Uncontrollable Circumstance Exception and avoid a negative payment adjustment for the Merit-based Incentive Payment System (MIPS) in 2021?
MIPS-eligible clinicians who are located in the affected areas will be automatically identified by the Centers for Medicare & Medicaid Services (CMS), so nothing is required of you! Visit
https://www.fema.gov/disaster/4468
to identify the Florida counties affected.*
*Note: Review each eligible clinician’s address in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS) to ensure it reflects the correct address for your practice.
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Download the Latest Version of the SRA Tool
The Office of the National Coordinator (ONC) and the Office for Civil Rights (OCR) announced the release of version 3.1 of the Security Risk Assessment (SRA) Tool.
The tool is now more user-friendly, with helpful new features, such as:
- Enhanced user interface and improvement of user experience
- Modular workflow
- Custom assessment logic
- Progress tracker
- Threats and vulnerabilities rating
- Detailed reports
- Business associate and asset tracking
For more information:
*HHS = Health and Human Services Administration
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MIPS Improvement Activities Validation Criteria Call for TEP
CMS is seeking nominations for the 2020 MIPS Improvement Activities Validation Criteria Technical Expert Panel (TEP). As part of its improvement activity development process, the Practice Improvement and Measures Management Support (PIMMS) contract team convenes groups of stakeholders and experts who contribute direction and thoughtful input to the development and maintenance of improvement activities. CMS is seeking a TEP of approximately 8–10 clinicians and individuals with the following perspectives and areas of expertise:
- Subject matter/clinical expertise with Improvement Activities
- Consumer/patient/family (non-medical caregiver) perspective
- Performance measurement and quality improvement
The nomination period closes at 5:00 p.m. PST on November 29, 2019
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Maximize Your MIPS Quality Score and Protect Your Patients This Flu Season
Influenza is a serious health threat, especially to vulnerable populations such as people age 65 and older, who are at high risk for hospitalization and developing serious complications.
Medicare Part B covers:
- Influenza virus vaccine once per influenza season.
- Additional influenza vaccines if medically necessary
Under MIPS in the Quality performance category
, you can report influenza vaccinations provided on each application via the measure below:
Additional educational resources on influenza vaccinations:
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HCQIS Access Roles and Profile (HARP)
Account Reminders
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The MIPS submission
window is quickly approaching. Have you established a HARP account and identified roles needed for submission? Check out some HARP Frequently Asked Questions at the
CMS HARP Help website
. If you have a HARP account, the following are some tips to keep your account active and how to create a strong password.
Passwords must:
- Be changed every 60 days.
- Be changed prior to expiration.
- Are changed by going to portal.cms.gov > My Profile>Click on Change My Profile>Change Password.
- Contain between eight and twenty characters.
- Contain at least one upper case letter, lower case letter, and number.
- Not contain a dictionary word of five letters or more.
- Not contain more than four sequential numbers, such as 1234.
- Contain a special character.
- Not contain these special characters: ? < > ( ) ' " ? | &.
Here are some examples of acceptable passwords:
- Hbfc#867 or H@ll0ween (CAP Initials of first and last name - @ - lower case business initials and 3 numbers)
- JA@hc876 (Josh Allen who works at Health Clinic)
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New QPP Tools and Resources
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QPP Frequently Asked Question of the Month
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Question:
We are scheduled to transition to a new electronic health record (EHR) system during the 2019 performance period. What does this mean for our quality measure reporting and meeting the data completeness threshold?
Answer:
In this situation, we encourage stakeholders to supply a report from the previous EHR for the first time period (as long as that EHR was also 2015 certified EHR technology [CEHRT]) and a report from the new EHR for the second time period and aggregate the data for the full 12 months into one report prior to submitting to CMS. In other scenarios where data for the full 12 months is unavailable (for example, if aggregation of EHR reports is not possible), we clarify that the data completeness threshold is always calculated based on a 12-month period.
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Upcoming Learning Forum Fridays (LFF) Events
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December 13, 2019
1 p.m. ET
Series Finale: QPP Champions Panel
Learning objectives:
- Describe best practices to MIPS submission.
- Identify lessons learned in MIPS reporting and preparation.
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Did You Miss the November 8 LFF Webinar?
Do not forget to register for upcoming webinars and browse past webinars.
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Centers for Medicare & Medicaid Services Updates
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Implications of the Year 4 Final Rule for Solo and Small Group Practices
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Tuesday, December 10, 2019,
11:00 a.m. ET
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Thursday, December 12, 2019,
3:30 p.m. ET
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Earn CME Credit With These 2019 CME Modules
CMS has posted six continuing medical education (CME) modules on MIPS. You can access them by logging into your
Medicare Learning Network (MLN) account
or creating one at the
MLN website
. Once logged in, type the name of the module into the search bar at the top of the website to find it.
The new MIPS CME modules include:
- QPP 2019 Overview
- QPP MIPS: Participation in 2019
- QPP MIPS: Quality Performance Category in 2019
- QPP MIPS: Promoting Interoperability Performance Category in 2019
- QPP MIPS: Improvement Activities in 2019
- QPP MIPS: Cost Performance Category in 2019
For More Information:
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Virtual Group Election Period Ends December 31!
If you are interested in forming a virtual group for the 2020 MIPS performance year, the election period started October 1, 2019 and you must submit your election to CMS
via email
before
December 31, 2019
.
What is a Virtual Group?
A virtual group is a combination of two or more Taxpayer Identification Numbers (TINs) assigned to:
- One or more solo practitioners (who are MIPS-eligible clinicians); or
- One or more groups consisting of 10 or fewer clinicians (including at least 1 MIPS-eligible clinician); or
- Both (solo practitioners and groups of 10 or fewer clinicians) that elect to form a virtual group for a performance period for a year
Note:
A solo practitioner or group can
only participate in one virtual group
during the performance period.
What is the Election Process?
There is a two-stage election process for forming a virtual group:
Stage 1 (optional)
Stage 2 (required)
As part of Stage 2 of the election process, you must:
- Have a formal written agreement
- Name an official virtual group representative
- Submit the virtual group’s election via e-mail to CMS at MIPS_VirtualGroups@cms.hhs.gov by December 31, 2019
- Determine group size and low-volume threshold
Download the
2020 Virtual Groups Toolkit
(ZIP) to learn more about the election process and how to participate in MIPS as a virtual group in 2020.
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Upcoming MIPS Important Dates and Deadlines
CMS would like to remind clinicians of important upcoming MIPS dates and deadlines:
- December 31, 2019 — 2020 virtual group election period closes
- January 2, 2020 — 2019 MIPS performance period data submission window opens
- March 31, 2020 — 2019 MIPS performance period data submission window closes
To learn more, visit the
QPP website and access the following resources:
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2019 Final MIPS Eligibility Determination
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Subscribe to Get the Information You Need
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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
.
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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.
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