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Home » Health care reform
CMS

Reminder: 2022 MIPS data submission period ends March 31

March 8, 2023 by

MIPS Eligible clinicians can submit their 2022 data through March 31. The Centers for Medicare & Medicaid Services (CMS) has opened the data submission period for Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in the 2022 performance year of the Quality Payment Program (QPP). Data can be submitted and updated until 8 p.m. ET March 31. How to submit your 2022 MIPS data Clinicians will follow the steps outlined below to submit their data: Go to the Quality Payment Program sign in page. Sign in using your QPP access credentials (see below for directions). Submit your MIPS data for the 2022 performance year or review the data reported on your behalf by a third party. (You can’t correct errors with your data after the submission period, so it’s important to make sure the data submitted on… . . . read more.

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HIPAA

Proposed rule would standardize how to send health care attachments

December 26, 2022 by

It might get easier for your medical office to send healthcare attachments and electronic signatures. The Centers for Medicare & Medicaid Services (CMS), has issued a proposed rule, “Adoption of Standards for Health Care Attachments Transactions and Electronic Signatures, and Modification to Referral Certification and Authorization Transaction Standard (CMS-0053-P).” If finalized, the proposed rule, would adopt standards for “health care attachments” transactions, such as medical charts, x-rays, and provider notes that document physician referrals, and office or telemedicine visits. The modifications to the HIPAA transactions would support both health care claims and prior authorization transactions, standards for electronic signatures to be used in conjunction with health care attachments transactions, and a modification to the standard for the referral certification and authorization transaction. The is a part of ongoing efforts to… . . . read more.

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CMS

2022 APM incentive payment public notice deadline Tuesday

October 30, 2022 by

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.

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MIPS

Submit your Promoting Interoperability measures and improvement activities

April 4, 2022 by

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.

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MOM WEBINAR

Learn about changes and updates to telehealth

March 25, 2022 by

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.

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BILLING

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

July 22, 2021 by

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.

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QPP

First snapshot ready for APM status and data

July 13, 2021 by

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.

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REIMBURSEMENT

CMS reweighting 2020 MIPS cost performance category

May 20, 2021 by

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.

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TOOL

HIPAA compliance checklist

May 14, 2021 by

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.

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QPP

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

December 7, 2020 by

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.

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