• Thursday, August 09, 2018 8:33 AM | Deleted user

    The 2018 Quality Payment Program Exception Applications for the Promoting Interoperability (PI) performance category and for Extreme and Uncontrollable Circumstances for the Merit-based Incentive System (MIPS) are now available on the Quality Payment Program website.

    Promoting Interoperatability Hardship Exceptions

    If you’re participating in MIPS during the 2018 performance year as an individual, group, or virtual group—or participating in a MIPS Alternative Payment Model (APM)—you can submit a Quality Payment Program Hardship Exception Application for the PI performance category, citing one of the following specified reasons for review and approval:

    • MIPS-eligible clinicians in small practices (new for 2018)
    • MIPS-eligible clinicians using decertified EHR technology (new for 2018)
    • Insufficient Internet connectivity
    • Extreme and uncontrollable circumstances
    • Lack of control over the availability of certified electronic health record technology (CEHRT)

    An approved Quality Payment Program Hardship Exception will:

    • Reweight your PI performance category score to 0 percent of the final score
    • Reallocate the 25 percent weighting of the PI performance category to the Quality performance category

    Please note that simply not using CEHRT does not qualify you for reweighting of your PI performance category.

    You must submit a hardship exception application by December 31, 2018 for CMS to reweight the PI performance category to 0 percent.

    Extreme and Uncontrollable Circumstances

    MIPS eligible clinicians who are impacted by extreme and uncontrollable circumstances may submit a request for reweighting of the Quality, Cost, and Improvement Activities performance categories.

    "Extreme and uncontrollable circumstances" are defined as rare events (highly unlikely to occur in a given year) entirely outside your control and the facility in which you practice.

    These extreme and uncontrollable circumstances would cause you to be unable to collect information necessary to submit for a performance category, or to submit information that would be used to score a performance category for an extended period of time (for example, 3 months unable to collect data for the Quality performance category). In your application, you must indicate the performance categories that were subject to an extreme and uncontrollable circumstance and how the circumstance affected your ability to collect or submit data for the 2018 MIPS performance year.

    The application for extreme and uncontrollable circumstances must be submitted by December 31, 2018 for the 2018 MIPS performance year.

    For More Information:

    Visit the Quality Payment Program Website
  • Thursday, August 09, 2018 8:30 AM | Deleted user

    If you submitted 2017 Merit-based Incentive Payment System (MIPS) data through the Quality Payment Program website, you can now view your performance feedback and MIPS final score.

    CMS originally displayed a single payment adjustment amount, which included an additional adjustment for exceptional performance available to MIPS eligible clinicians and groups with a final score of 70 or greater. However, based on feedback from various clinicians and groups, we have updated the system so that your MIPS payment adjustment, and if applicable, your additional adjustment for exceptional performance, are now displayed separately. The system will continue to display your total MIPS payment adjustment, which is a sum of your MIPS performance and exceptional performance.

    How to Access Your Final Score and Feedback

    You can access your 2017 MIPS performance feedback and final score by:

    Upcoming Office Hours

    CMS will be hosting an office hours session on August 14 to provide a brief overview of MIPS 2017 performance feedback and targeted review and to answer frequently asked questions.

    Title: Performance Feedback and Targeted Review Office Hours Session

    Date: Tuesday, August 14, 2:00 – 3:00 p.m. ET

    Register: https://meetingconnect.webex.com/meetingconnect/onstage/g.php?MTID=e91df49e0f68fa7073866f0307f82b53b

    Resources

    Questions?

    If you have questions about your performance feedback or MIPS final score, please contact the Quality Payment Program by:

  • Thursday, August 02, 2018 1:49 PM | Deleted user

    Please see flyer for a webinar sponsored by the Chief Medical Officers of CMS Regions VII, IX, and X to discuss the Notice of Proposed Rulemaking for Year 3 of the Quality Payment Program. You can click here to register:

    https://meetings-cms.webex.com/meetings-cms/onstage/g.php?MTID=e26dafc9adf37584d02153671a5fb96ab

    Flyer: QPP Webinar Invitation2.pdf

  • Thursday, August 02, 2018 11:22 AM | Deleted user

    Wednesday, August 22 from 1:30 to 3 pm

    Register for Medicare Learning Network events.

    Proposed changes to the CY 2019 Physician Fee Schedule would increase the amount of time doctors and other clinicians spend with their patients by reducing the burden of Medicare paperwork.  During this listening session, CMS experts will briefly cover three provisions from the proposed rule and address your clarifying questions to help you formulate your written comments for formal submission:

    • Streamlining Evaluation and Management (E/M) payment and reducing clinician burden
    • Advancing virtual care
    • Continuing to improve the Quality Payment Program to reduce clinician burden, focus on outcomes, and promote interoperability

    We encourage you to review the proposed rule prior to the call, as well as the following materials on the provisions to be covered:

    Note: Feedback received during this listening session will not be considered formal comments on the rule. See the proposed rule for information on submitting these comments by September 10, 2018.

    Target Audience: Medicare Part B fee-for-service clinicians; office managers and administrators; state and national associations that represent healthcare providers; and other stakeholders.
  • Tuesday, July 31, 2018 9:54 AM | Deleted user

    CMS will be hosting a webinar to present the benefits of using the MSPRP, this will include newly available features. The webinar will be held August 16, 2018. The notice for the webinar is available in the Downloads section of the Coordination of Benefits Overview What’s New page on CMS.gov and includes all webinar information

  • Tuesday, July 31, 2018 9:50 AM | Deleted user


    NCQA updates the NYS PCMH publication annually to clarify guidance and refine criteria expectations. Download the NYS PCMH Standards and Guidelines (2017 Edition, Version 3) to review.

    Highlights of the update include:

    • Organizations with two or more sites are now allowed to share or partially share an additional 21 criteria across practice sites, saving time and reducing documentation.
    • Updates to guidance language for clarity of criteria.
    • Updated selected concept and competency descriptions to align with criteria included in the concepts and competencies.

    Summary of Changes to PCMH Standards and Guidelines

    Practices may share evidence for these criteria:

    KM 02-KM 05

    AC 05

    CC 01

    CC 02

    CC 04

    CC 10

    CC 14-CC 16

    CC 18

    CC 19

    QI 15

    QI 16

    BH 02

     

     

    Criteria

    Change

    CM 04-CM 08

    Practices may share examples for CM 04-CM 08, although each site must still provide a Record Review Workbook.

    QI 06

    Practices must provide site-specific evidence for QI 06.

    TC 01, TC 04

    Clarified requirements for these criteria.

    TC 03

    Removed the reference to health information exchanges (HIE).

    Updated guidance to clarify that participating in an ACO or clinically integrated network does not meet this criterion.

    TC 09

    Clarified the criterion language to require practices to periodically remind patients of the roles and responsibilities of the medical home.

    CM 05

    Clarified criterion language to require practices to give written care plans to patients electronically or as a printed document.

    CC 09/BH 05

    Removed text: "The practice must provide a report, log or electronic tracking system as evidence of implementation."

    CC 14

    Updated evidence from "Report" to "Evidence of implementation."

    CC 16

    Evidence updated from "Evidence of follow-up" to "Evidence of implementation." 

    CC 18-CC 19

    Removed the requirement for practices to provide at least three examples of data exchange (CC 18) and obtaining discharge summaries (CC 19).

    QI 07

    Clarified the criteria's language and guidance to further differentiate between QI 05 and QI 07.

    QI 10

    Clarified the criterion language to state that practices that have met their appointment availability access goals may focus on improvement in another patient-access area.

    QI 15-QI 16

    Modified criteria language to clarify that practices may report clinician-level data or practice-level data.

    Summary of Changes to NYS PCMH Policies and Procedures

    • Rearranged and updated portions of the Overview section for clarity.
    • Updated the Commit, Transform and Succeed sections to align with changes to the Q-PASS process.
    • Added a section describing the role of the prevalidated vendor and NCQA investigation.
    • Expanded the Reportable Events Policy to clarify when and how to inform NCQA of reportable events such as mergers, acquisitions, consolidations and investigations.

    Thank you for your ongoing commitment to delivering high-quality, patient-centered care. If you have questions, submit them through My NCQA.


  • Friday, July 27, 2018 11:52 AM | Deleted user

    In case you missed it last week, see below for a link to the webcast of the panel discussion on Evaluation & Management Coding:

    • Title: CMS Panel Discussion on E/M Coding Reform
    Link: https://youtu.be/W2QBTQNxfSY
  • Friday, July 27, 2018 11:51 AM | Deleted user

    CMS is hosting a series of webinars on the Merit-based Incentive Payment System (MIPS) Performance Categories for Year 2 (2018) of the Quality Payment Program. The webinars will provide an overview of the Improvement Activities and Quality performance categories for Year 2 (2018). CMS subject matter experts will cover topics including category requirements, scoring details, and data submission mechanisms.

    Below are details for the following webinars and how to register:

    MIPS Improvement Activities Performance Category for Year 2 (2018) Overview Webinar

    MIPS Quality Performance Category for Year 2 (2018) Overview Webinar

    The audio portion of these webinars will be broadcast through the web. You can listen to the presentation through your computer speakers. CMS will open the phone line for the Q&A portion, but if you are unable to hear audio through your computer speakers, please contact CMSQualityTeam@ketchum.com.
  • Friday, July 27, 2018 11:50 AM | Deleted user

    CMS Will Answer Questions about Performance Feedback & Targeted Review During Two “Office Hours” Sessions

    If you participated in the Merit-based Incentive Payment System (MIPS) in 2017, your MIPS final score and performance feedback are now available for review on the Quality Payment Program website. If you believe that an error has been made in your 2019 MIPS payment adjustment calculation, you can request a targeted review until October 1, 2018 at 8:00 pm (EDT).

    CMS will be hosting two “Office Hours” sessions over the next few weeks to:

    • Provide a brief overview of MIPS 2017 performance feedback and targeted review
    • Answer some frequently asked questions
    • Highlight helpful performance feedback and targeted review resources available

    We encourage you to email your questions prior to the Office Hours sessions. If you are interested in submitting a question to be considered, please email CMSQualityTeam@ketchum.com. Please note, this email address is only for office hours questions; do not use this to submit a targeted review request.

    Office Hours Details

    Title: Performance Feedback and Targeted Review Office Hours Session

    Date: Tuesday, July 31, 12:00 – 1:00 p.m. ET

    Register: https://meetingconnect.webex.com/meetingconnect/onstage/g.php?MTID=e4c6390a9eb367919b4e5c25c96107d43

     

    Title: Performance Feedback and Targeted Review Office Hours Session

    Date: Tuesday, August 14, 2:00 – 3:00 p.m. ET

    Register: https://meetingconnect.webex.com/meetingconnect/onstage/g.php?MTID=e91df49e0f68fa7073866f0307f82b53b

    Please note: Space for these sessions is limited. Register now to secure your spot. The audio portion of the sessions will be broadcast through the web. You can listen to the presentation through your computer speakers.

    Learn More

    For more information on performance feedback and targeted review, the following resources are available:

    Questions? Contact the Quality Payment Program by:

  • Friday, July 27, 2018 11:49 AM | Deleted user

    Updates to the 2018 CMS QRDA III Implementation Guide

    The Centers for Medicare & Medicaid Services (CMS) has published an updated 2018 CMS Quality Reporting Document Architecture Category III (QRDA III) Implementation Guide (IG) for Eligible Clinicians and Eligible Professionals. This is an update to the 2018 CMS QRDA III IG for Eligible Clinicians and Eligible Professionals originally published on 11/27/2017 and updated previously on 3/12/2018.

    This latest update includes:

    • Renaming of the Merit-based Incentive Payment System (MIPS) performance category Advancing Care Information (ACI) to Promoting Interoperability (PI).
    • Changes to performance period reporting:

      The performance period under MIPS can be reported at either of the following levels:
    1. The individual measure level for the MIPS quality measures and at the individual activity level for the MIPS improvement activities (IA), as defined by CMS, or
    2. The performance category level for Quality and IA performance categories, as previously specified in the 2018 CMS QRDA III IG.
    • Performance period reporting for PI will remain at the performance category level only.
    • Performance period reporting for Comprehensive Primary Care Plus (CPC+) for the Quality performance category remains at the category level only.
    • New CMS program name code created “MIPS_VIRTUALGROUP” to support MIPS virtual group reporting.
    • Eight new PI measure identifiers have been developed that indicate active engagement with more than one registries.
      The new measure identifiers consist of an existing measure identifier appended with “_MULTI”. For example, the new measure identifier “PI_PHCDRR_1_MULTI” indicates immunization registry reporting for multiple registry engagement.

    Additional QRDA-Related Resources:

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