If you participated in the Merit-based Incentive Payment System (MIPS) in 2017, your MIPS final score and performance feedback are available on the Quality Payment Program website. The payment adjustment you will receive in 2019 is based on this final score. A positive, negative, or neutral payment adjustment will be applied to the Medicare paid amount for covered professional services furnished under the Medicare Physician Fee Schedule in 2019.
MIPS eligible clinicians or groups (along with their designated support staff or authorized third-party intermediary), including those who are subject to the APM scoring standard, may request for CMS to review their performance feedback and final score through a process called targeted review if they believe an error has been made in the 2019 payment adjustment calculation.
Please read the following article from Modern HealthCare, as well:
Please note, on September 13, 2018, CMS updated MIPS 2017 performance feedback for clinicians affected by scoring issues previously identified through the targeted review process. Additionally, to ensure that we maintain the budget neutrality required by law under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), some clinicians will see slight changes in their payment adjustment. If you believe an error exists in your 2019 MIPS payment adjustment calculation, you can request a targeted review by the extended deadline of October 15 at 8:00 PM EDT-which is just 20 days away. To learn more, view this 2017 MIPS Performance Feedback Statement.
When to Request a Targeted Review
The following are examples of circumstances in which you may wish to request a targeted review:
This is not a comprehensive list of circumstances. CMS encourages you to contact the Quality Payment Program if you believe a targeted review of your MIPS payment adjustment (or additional MIPS payment adjustment) is warranted. We’ll help you to determine if you need to submit a targeted review request.
How to Request a Targeted Review
You can access your MIPS final score and performance feedback and request a targeted review by:
When evaluating a targeted review request, we will generally require additional documentation to support the request. If your targeted review request is approved, CMS will update your final score and associated payment adjustment (if applicable), as soon as technically feasible. CMS will determine the amount of the upward payment adjustments after the conclusion of the targeted review submission period. Please note that targeted review decisions are final and not eligible for further review.
For More Information
To learn more about the steps for requesting a targeted review, please review the following:
Questions?
If you have questions about your MIPS performance feedback or final score, or whether you should submit a targeted review request, please contact the Quality Payment Program by:hone: 1-866-288-8292/TTY: 1-877-715-6222; or email: QPP@cms.hhs.gov
2019 flu vaccine code.pdf
2018-2019 flu season.pdf
The American Cancer Society and the YMCA of Greater Rochester are hosting a Policy Forum on children and cancer prevention.
The invite and registration link are finalized! To register, simply go to: https://www.acscan.org/events/children-cancer-prevention-policy-forum
CMS has posted the following new Merit-based Incentive Payment System (MIPS) resources on CMS.gov:
FROM NYS WORKERS' COMP BOARD As of September 10, 2018, the Special Funds Conservation Committee (SFCC) will no longer be administering workers compensation, volunteer firefighter, and volunteer ambulance worker claims.
These claims are being transferred to new third-party administrators (TPAs), who will assume all claims administration services.
Notifying Injured Workers
Injured workers have been notified of the name and contact information of their new TPA, and have been advised to inform their legal representatives and medical providers of this change.
Medical Reporting and Billing
All requests for treatment authorization on and after September 10, 2018, must be sent to the correct TPA for the injured worker.
All medical bills received by SFCC in error during this period of transition will be forwarded to the proper TPA for resolution and payment.
Finding the New TPA
If you are providing medical treatment or legal representation for an injured worker who lists SFCC as their insurer on or after September 10, 2018, please inquire further, as the SFCC will no longer be the claims administrator at that time.
For information about the new TPA, the injured worker (or your office if you have previously submitted Form OC-400 or medical bills to the Workers Compensation Board for that person in that workers compensation case) may contact SFCC or the Workers Compensation Board.
Contact SFCC Buffalo: (716) 686-5700 Dewitt: (315) 445-9405 New York City: (212) 883-3900
Contact the Workers Compensation Board (877) 632-4996 general_information@wcb.ny.gov
Please note, the distribution of claims amongst the new TPAs does not follow any identifiable pattern (such as injured worker last name or injury date) that can be shared ahead of or after the transfer; however, the SFCC and the Board can provide this information to you on a case-by-case basis upon your request.
http://bit.ly/2018FluForm
ECHO® MOLST Launches September 13!
By Patricia Bomba, MD, MACP, ECHO® MOLST Program Director
At long last, the first ECHO® MOLST: Honoring Patient Preferences at End-of-life clinic will be held on September 13. The initial series will run for eight sessions through November 8. The weekly ECHO® clinics, which are like virtual grand rounds, combine mentoring and patient case presentations. See details on the ECHO MOLST flyer.
Space is limited to the first 50 “spokes.” A spoke is a single site that can include multiple physicians, nurse practitioners and other clinicians. Sign up now to participate by emailing Meg.Greco@excellus.com, ECHO MOLST coordinator. By registering now, you will be guaranteed a spot on the spoke and will receive onboarding training to make the most of ECHO MOLST.
Free CME will be provided. The University of New Mexico School of Medicine, Office of Continuing Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Office of Continuing Medical Education designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
ECHO MOLST provides seasoned physicians and nurse practitioners the opportunity to present challenging clinical cases and pose clinical, ethical and legal questions to the participants. MOLST experts will serve as mentors and colleagues, sharing their medical knowledge and expertise with physicians, nurse practitioners and other clinicians using the “All teach. All Learn.” ECHO model.
The launch of ECHO MOLST was delayed to the fall while awaiting new legislative changes and approval of the proposed revised MOLST form. The key target audience includes physicians and nurse practitioners who will be impacted by the new NYSPHL and MOLST form changes. The topics for the initial series is based on the “Core Elements for MOLST & eMOLST Education,” approved by the MOLST Statewide Implementation Team in 2014, that outline the educational needs based on clinical roles and the 8-Step MOLST Protocol. Combining the case-based ECHO model with the “Core Elements” will meet the needs of the target audience.
Project ECHO was identified as a platform for continued sustainable MOLST education in 2017. The core MOLST team from Excellus BlueCross BlueShield (MOLST Program Director, Program Manager & Coordinator) attended ECHO immersion training in October 2017.
The ECHO MOLST planning group was formed in 2018 to launch ECHO MOLST: Honoring Patient Preferences at End-of-life. Members include the core MOLST team from Excellus BCBS: Patricia Bomba, MD, MACP, Katie Orem, MPH, Meg Greco, MPA and key leaders from IPRO, one of the nation’s premier quality evaluation organizations: Sara Butterfield, RN, BSN, CPHQ; Carolyn Kazdan, MHSA, NHA; L. Christine Stegel RN, MSN, CPHQ, Fred Ratto Jr., BA, CPH and Lynn Wilson, MS.
Medicare Diabetes Prevention Program: New Covered Service Call
Date: Wednesday, September 26
Time: 2 to 3 pm ET
Audience: Medicare fee-for-service providers
Register here for Medicare Learning Network events.
The 2019 Medicare and You Handbook includes information on the Medicare Diabetes Prevention Program, a new Medicare-covered service. Help your patients prevent or delay Type 2 diabetes and understand their treatment options. During this call, learn about the service, eligibility requirements, and how to refer your patients. A question and answer session follows the presentation.
The New York State Office of Alcoholism and Substance Abuse Services (NYS OASAS) today announced the expansion of the inpatient detox facility operated by Helio Health in Rochester. The facility will now have 40 beds available, an increase from the previous total of 25 beds. These additional beds are expected to be operational by the beginning of 2019. The New York State Office of Alcoholism and Substance Abuse Services, which already provides approximately $1.3 million for Helio Health services in Monroe County, is providing $450,000 in annual operational funding to support the new beds.
“We’re investing in treatment facilities across the state to help save lives, and ensure that individuals struggling with addiction have the resources they need to recover,” said Lieutenant Governor Kathy Hochul, Co-Chair of the Heroin and Opioid Abuse Task Force. “We’re aggressively working to combat the opioid epidemic in New York, and the expansion of Helio Health in Rochester will provide additional beds for residents of Monroe County battling addiction and seeking services and support.
“Detox is a vital part of the OASAS continuum of care, and is the first step for many people in their recovery from substance use disorders,” OASAS Commissioner Arlene González-Sánchez said. “Thanks to Governor Cuomo’s efforts to add more beds, more people in Monroe County will be able to access this service closer to where they live.”
Medically Supervised Withdrawal and Stabilization services offer medical assessment, information about recovery support, family treatment, clinical services, and medication to manage withdrawal symptoms. Detox programs are a short-term service designed to prepare and connect people to longer term treatment.
The Helio Health facility is located at 1350 University Avenue in Rochester.
New York State Senator Rich Funke said, “As a member of the Senate Task Force on Heroin and Opioid Addiction, I will continue to advocate for additional treatment beds and support services for our community. Every individual deserves the chance to begin their road to recovery as quickly and efficiently as possible. I commend the organizations in the Rochester and Finger Lakes region for their continued efforts in our fight to address this growing public health epidemic.”
New York State Assemblymember Harry B. Bronson said, “The opioid epidemic continues to plague our community, and I applaud Governor Cuomo and the Office of Alcoholism and Substance Abuse for committing additional resources to this fight. I also wish to thank Helio Health for providing families with the treatment options they need. Detox is the first step to getting people on the road to recovery, and by expanding the number of beds available to individuals beginning that journey, we can reduce the harm that opioid addiction is inflicting on our families and our community.”
New Yorkers struggling with an addiction, or whose loved ones are struggling, can find help and hope by calling the state’s toll-free, 24-hour, 7-day-a-week HOPEline at 1-877-8-HOPENY (1-877-846-7369) or by texting HOPENY (Short Code 467369). Available addiction treatment including crisis/detox, inpatient, community residence, or outpatient care can be found using the NYS OASAS Treatment Availability Dashboard at FindAddictionTreatment.ny.gov or through the NYS OASAS website. Visit CombatAddiction.ny.gov to learn more about the warning signs of addiction, review information on how to get help, and access resources on how to facilitate conversations with loved ones and communities about addiction. For tools to use in talking to a young person about preventing alcohol or drug use, visit the State’s Talk2Prevent website.
Registration is open for our "Innovation in Action" event on September 12! We'll be showcasing how technology is changing the trajectory of advanced heart failure, as well as new technology for opening diseased blood vessels. Register here: http://bit.ly/2PBHE7D
