Volume 2 Ed. 9 | September 26, 2019
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New Event Added to Automate Extreme and Uncontrollable Circumstances for MIPS
Merit-based Incentive Payment System (MIPS)-eligible clinicians in affected areas will be automatically identified and receive a neutral payment adjustment for the 2021 MIPS payment year. During the data submission period for the 2019 performance period (January 2, 2020 to March 31, 2020), all four performance categories for these affected clinicians will be weighted at zero percent, resulting in a score equal to the performance threshold. The automatic extreme and uncontrollable circumstance policy will not apply to MIPS-eligible clinicians in MIPS Alternative Payment Models (MIPS APMs) in 2019 or to MIPS group or virtual-group participation.
Hurricane Dorian
Federal Emergency Management Agency (FEMA)-designated disaster areas resulting from
Hurricane Dorian will be posted on the FEMA website every 24 hours. MIPS-eligible clinicians are encouraged to check the FEMA website to determine if their county qualifies for the automatic extreme and uncontrollable circumstances exception.
For More Information
Last Day to Begin 90-Day Performance Period—October 3
MIPS requires eligible clinicians to report measure data for the Promoting Interoperability (PI) and Improvement Activities (IA) performance categories for 90 continuous days or more during 2019. Keep in mind that October 3, 2019 is the last day to begin collecting data collection in order to meet this 90-continuous day requirement for the 2019 performance period.
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New Quality Payment Program (QPP)
Tools and Resources
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QPP Frequently Asked Question of the Month
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Question: Why is our payment adjustment so low when our final score is so high?
Answer:
The Medicare Access and Children's Health Insurance (CHIP) Reauthorization Act of 2015 (MACRA) requires MIPS to be a budget-neutral program, which generally means that the projected negative adjustments must be balanced by the projected positive adjustments. The positive payment adjustment you see is a result of high participation rates in combination with a high percentage of participating clinicians earning a final score well above the low performance threshold of 15 points.
The magnitude of the payment adjustment amount is influenced by the performance threshold and the distribution of final scores in comparison to the performance threshold in a given year. The program and incentives will continue to evolve. As the performance threshold increases and more accurately reflects the performance of clinicians in the program, the opportunity for larger payment adjustments also increases.
If you need additional information, the Centers for Medicare & Medicaid Services (CMS) has a
targeted review fact sheet
available in the QPP Resource Library.
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Upcoming Learning Forum Fridays (LFF) Events
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October 11, 2019
1 p.m. ET
QPP Home Plate: Grand Slam Your Performance Goals
Learning objectives:
- Identify the performance needed to maximize 2019 MIPS final scoring.
- Apply strategies to improve their performance to meet the 2019 QPP requirements.
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November 8, 2019
1 p.m. ET
Security Risk Analysis and Possible Strikes
Learning objectives:
- Define the components of an SRA.
- Discuss common challenges in preparing an SRA.
- Identify tools and resources to develop an SRA.
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Did You Miss the September 13 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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2020 Proposed Physician Fee Schedule & Proposed Rule for the Quality Payment Program Comment Period Ends Tomorrow, September 27
Key proposals for the 2020 performance year of the Quality Payment Program (QPP) include:
- Increasing the performance threshold from 30 points to 45 points.
- Revising the category weights for Quality (decreases from 45 percent to 40 percent) and Cost increases from 15 percent to 20 percent).
- Increasing the data completeness threshold for the quality data that clinicians submit.
- Increasing the threshold for clinicians who complete or participate in the Improvement Activity for group reporting.
- Updating requirements for Qualified Clinical Data Registry (QCDR) measures and the services that third-party intermediaries must provide (beginning with the 2021 performance period).
- Revising the specifications for the Total Per Capita Cost (TPCC) and Medicare Spending Per Beneficiary Clinician (MSPB Clinician) measures.
For More Information
- CMS is seeking comments on the proposed rule now until September 27, 2019.
- When commenting, refer to file code: CMS-1715-P. Fax transmissions will not be accepted. Use one of the following ways to officially submit your comments:
- Electronically through Regulations.gov
- Regular mail
- Express or overnight mail
- Hand or courier delivery
- Fact sheet – Offers an overview of the QPP Proposed policies for 2020 (year 4) and compares these policies to the current 2019 (year 3) requirements.
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Deadline to Submit a MIPS Targeted Review Request
Is Four Days Away
If you participated in the MIPS in 2018, your performance feedback, which includes your MIPS final score and payment adjustment factor(s), are now available for review on the
QPP website.
MIPS-eligible clinicians or groups (along with their designated support staff or authorized third-party intermediary), including Alternative Payment Model (APM) participants, may request CMS to review their performance feedback and final score calculation through a process called
targeted review. The deadline to submit your request is
September 30, 2019 at 8:00 p.m. EDT,
which is four days away.
You can access your MIPS final score, performance feedback, a request a targeted review by:
- Visiting the QPP website.
- Logging in using your Healthcare Quality Information System (HCQIS) Access Roles and Profile System (HARP) credentials; these are the same credentials that allowed you to submit your MIPS data. Please refer to the QPP Access User Guide for additional details, and if you do not have a HARP account or role.
For More Information
To learn more about the steps for requesting a targeted review, please review the following:
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How to Transform Your Practice Workflow to Succeed in MIPS: Advice for Solo and Small Group Practices
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Tuesday, October 15, 2019,
3:30 p.m. ET
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Thursday, October 17, 2019,
11:00 a.m. ET
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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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