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CMS

2022 APM incentive payment public notice deadline Tuesday

The Centers for Medicare & Medicaid Services (CMS) previously published 2022 Alternative Payment Model (APM) Incentive Payment details on the Quality Payment Program (QPP) website. To access this information, clinicians and surrogates can now log in to the QPP website using their HARP credentials. Eligible clinicians who were Qualifying APM Participants (QPs) based on their 2020 performance should have begun receiving their 2022 5% APM Incentive Payments earlier this summer. CMS has posted the Advanced Alternative Payment Model (APM) Incentive Payments for 2022 for more details.  More information is also available on the Federal Register. If you have not received your payment, you should check for your name on the 2022 QP Notice for APM Incentive Payment Zip File, which indicates that you will need to verify your Medicare billing information. If you do not verify your Medicare billing information by… . . . read more.

MIPS

Submit your Promoting Interoperability measures and improvement activities

The Centers for Medicare & Medicaid Services (CMS) reminds you to submit Promoting Interoperability measures and improvement activities for consideration for future years of the Merit-based Incentive Payment System (MIPS). The MIPS Annual Call for Measures and Activities process allows clinicians, professional associations and medical societies that represent clinicians, researchers, consumer groups, and others to identify and submit measures and activities. Currently, CMS is accepting submissions for: Measures for the Promoting Interoperability performance category Activities for the improvement activities performance category What CMS is looking for For Promoting Interoperability: CMS is looking for specific measures that build on the advanced use of certified EHR technology (CEHRT) using 2015 Edition Certification Standards and Criteria; promote interoperability and health information exchange; improve program efficiency, effectiveness, and flexibility; provide patients access to their health information; reduce clinician… . . . read more.

MOM WEBINAR

Learn about changes and updates to telehealth

There’s a lot you need to know about telehealth. That’s why Medical Office Manager is offering a webinar, Telehealth—What Managers Need to Know, on April 6. It’s free to Medical Office Manager members. Presenter Jen Bell of Karen Zupko and Associates will give you the tools and knowledge you need to comply with new telehealth regulations. Meanwhile here is Jen’s update on telehealth changes to early 2022. POS 10 Telehealth Provided in Patient’s Home Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology. Home may be defined to include temporary lodging (hotels, homeless shelters) and patient travels of short distance from the exact… . . . read more.

BILLING

Newly proposed Medicare Part B Physician Fee Schedule contemplates Making COVID-19 telehealth changes permanent

On July 13, 2021, CMS published its proposed physician fee schedule rule for FY 2022. One of the key items is the proposal to make the temporary change allowing Medicare providers to deliver healthcare services via telehealth a permanent part of Medicare Part B. The Proposed Medicare Changes During the public health emergency (PHE), Congress added the home of the beneficiary as a permissible originating site for telehealth services for the purposes of diagnosis, evaluation or treatment of a mental health disorder. In addition to updating the fee schedule, the proposed CY2022 rule would allow certain services added to the Medicare telehealth list to remain on the list until the end of December 2023. This would allow CMS to continue to evaluate whether the temporary expansion of telehealth services adopted… . . . read more.

QPP

First snapshot ready for APM status and data

The Centers for Medicare & Medicaid Services (CMS) has updated its Quality Payment Program Participation Status Tool based on the first snapshot of Alternative Payment Model (APM) data. The first snapshot, posted July 8,  includes data from Medicare Part B claims with dates of service between Jan. 1, 2021 and March 31, 2021. The tool includes 2021 Qualifying APM Participant (QP) status and Merit-based Incentive Payment System (MIPS) APM participation status. To learn more about how CMS determines QP and the APM participation status for each snapshot, visit the APM Determination webpage on the QPP website. What does QP status mean? If you qualify as a QP, this means you are: Eligible for the 5% APM incentive bonus; Eligible for APM-specific rewards; and Exempt from participating in MIPS. How do I check my QP… . . . read more.

REIMBURSEMENT

CMS reweighting 2020 MIPS cost performance category

The Centers for Medicare & Medicaid Services (CMS) recognizes the impact of the COVID-19 pandemic public health emergency (PHE) on clinicians across the country and continues to offer flexibilities to provide relief where possible. Under § 414.1350(d)(3), the Merit-based Incentive Payment System (MIPS) cost performance category weight is 15% of the final score for the 2020 performance period/2022 MIPS payment year. CMS wants all MIPS eligible clinicians to know it is reweighting the cost performance category from 15% to 0% for the 2020 performance period. The 15% cost performance category weight will be redistributed to other performance categories in accordance with § 414.1380(c)(2)(ii)(D). See the table below for reweighting scenarios. Analysis of the underlying data for the 2020 performance year, in comparison to prior years’ data, shows that the volume… . . . read more.

TOOL

HIPAA compliance checklist

Having a complete HIPAA compliance program is important to your organization. Run through this HIPAA compliance checklist to see if you have your foundation of HIPAA compliance in place and easily retrievable. HIPAA Policies and Procedures HIPAA privacy policies, procedures, and forms HIPAA security policies, procedures, and forms HIPAA Breach Notification policy and procedure Most recent Notice of Privacy practices Privacy officer’s job responsibilities and contact information Security officer’s job responsibilities and contact information HIPAA workflows and evidence of compliance Most recent HIPAA Risk Analysis Most current HIPAA risk mitigation/risk management documentation Business Associate agreements with list of Business Associates Workforce HIPAA training, periodic HIPAA updates, HIPAA training log Password policies by system Workstation security practices (anti-virus, password requirement, password timeframes, workstation use, etc.) HIPAA documentation specific to the organization… . . . read more.

QPP

2018 performance info now available on Medicare Care Compare and in Provider Data Catalog

The Centers for Medicare & Medicaid Services (CMS) has added new performance information to the Doctors & Clinicians section of Medicare Care Compare and in the Provider Data Catalog (PDC), the successor websites to Physician Compare and the Physician Compare Downloadable Database. Medicare patients and caregivers can use the Care Compare website to search for and compare doctors, clinicians and groups who are enrolled in Medicare. Publicly reporting 2018 Quality Payment Program performance helps empower patients to select and access the right care from the right provider. Specifically, the 2018 Quality Payment Program performance information on Care Compare clinician and group profile pages includes: 77 MIPS quality measures reported by clinicians and displayed as measure-level star ratings on their profile pages; 84 MIPS quality measures reported by groups and displayed as measure-level star… . . . read more.

CMS

Resource ready for next year’s QRDA Implementation

The Centers for Medicare & Medicaid Services (CMS) has published the Quality Reporting Document Architecture (QRDA) Category III Implementation Guide (IG), Schematron, and Sample Files for Eligible Clinicians and Eligible Professionals Programs. The 2021 CMS QRDA III IG outlines requirements for eligible clinicians and eligible professionals to report electronic clinical quality measures (eCQMs), improvement activities (IA), and promoting interoperability (PI) measures for the calendar year 2021 performance period for these programs: · Quality Payment Program: Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs) · Comprehensive Primary Care Plus (CPC+) · Primary Care First (PCF) · Medicaid Promoting Interoperability (PI) The 2021 CMS QRDA III IG contains these high-level changes as compared with the 2020 CMS QRDA III IG: · Clarification of CPC+ QRDA III requirements in section 4.1 · Preliminary QRDA… . . . read more.

WORKING WITH PATIENTS

Prevent losing your patients by focusing on these 4 areas

By Nick Hernandez bio The changes to the healthcare industry are increasingly focused on addressing patients as consumers. Such a change means that providers must, of course, emphasize quality and work toward price transparency, but they must also seek to determine what patients desire most. It is this last effort that is transforming the healthcare sector more like businesses of other sectors; what consumers want, is what drives competition and ingenuity (and oftentimes commoditization). Perhaps more than ever, physicians need to be focused not just on attracting more patients, but also on not losing the patients they have. Under the healthcare reform legislation, the federal government views patients as consumers. Consequently, national attention has been placed on the patients as consumers, and that attention has not gone unnoticed. Indeed, patients… . . . read more.


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