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MIPS & QPP

Two data deadlines approaching this month

Two deadlines are coming up for physician practices: The Quality Payment Program Doctors and Clinicians Preview Period will close on March 25. And the data submission period for Merit-based Incentive Payment System eligible clinicians who participated in the 2020 performance year of the Quality Payment Program (QPP) ends March 31. Preview your performance information CMS opened the Doctors and Clinicians Preview Period on Jan. 25, 2021 at 10 a.m. The Preview Period provides an opportunity for doctors and clinicians to review their 2019 Quality Payment Program (QPP) performance information before it is publicly reported on clinician and group profile pages on Medicare Care Compare and in the Provider Data Catalog (PDC). You can access the secured Preview through the QPP website. Here’s where to find guidance on previewing your information: Pre-recorded Presentation: Preview Period: Performance Information for Doctors and… . . . read more.

CMS

CMS reopens applications for  COVID-19 MIPS Extreme and Uncontrollable Circumstances Policy 

Centers for Medicare & Medicaid Services continues to offer flexibilities to provide relief to clinicians responding to the 2019 Coronavirus (COVID-19) pandemic. CMS is applying the MIPS automatic extreme and uncontrollable circumstances (EUC) policy to all MIPS eligible clinicians for the 2020 performance period. It is also reopening the MIPS EUC application for individual MIPS eligible clinicians, groups, virtual groups, and Alternative Payment Model (APM) Entities through March 31. Applications received between now and March 31, 2021 won’t override previously submitted data for individuals, groups and virtual groups. This listserv will review what these flexibilities mean for: Individual clinicians, groups, and virtual groups that haven’t submitted data; Individual clinicians, groups, and virtual groups that have submitted data; and APM Entities. Individual clinicians, groups, and virtual groups that haven’t submitted data:… . . . read more.

MIPS

Extreme Circumstances Exception application deadline stretched to Feb. 1

To support clinicians during the COVID-19 public health emergency, the Centers for Medicare & Medicaid Services (CMS) is extending the 2020 Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances Exception application deadline to Feb. 1, 2021. For the 2020 performance year, CMS will be using its Extreme and Uncontrollable Circumstances policy to allow MIPS eligible clinicians, groups, and virtual groups to submit an application requesting reweighting of one or more MIPS performance categories to 0% due to the current COVID-19 public health emergency. If your practice has any concerns about the effect of the COVID-19 public health emergency on your performance data, including cost measures, for the 2020 performance period, submit an application now and cite COVID-19 as the reason for your application. If you have an approved application, you can… . . . read more.

AUTOMATIC PAYMENT

Clinicians in three disaster-struck states get MIPS break

If your medical practice is located within the disaster-struck states of Louisiana, California or Oregon you may be eligible for a payment adjustment. In response to the Federal Emergency Management Agency (FEMA) designation of Hurricane Laura and the California and Oregon wildfires as national disasters, CMS has determined that the automatic extreme and uncontrollable circumstances policy will be applied to Merit-based Incentive Payment System (MIPS) eligible clinicians in FEMA-identified areas under sections PA-A and PA-B in Louisiana,  California, and Oregon. MIPS eligible clinicians in these areas in 2020 will be automatically identified and receive a neutral payment adjustment for the 2022 MIPS payment year. During the data submission period for the 2020 performance year (Jan. 4, 2021 to March 31, 2021), all four performance categories for these clinicians will be weighted at… . . . read more.

QPP

Deadline Oct. 5 to ask for MIPS targeted review

If you participated in the Merit-based Incentive Payment System (MIPS) in 2019, your performance feedback, including your MIPS final score and payment adjustment factor(s), is now available for review on the Quality Payment Program website. This final score determines the payment adjustment you will receive in 2021, with a positive, negative, or neutral payment adjustment being applied to the Medicare paid amount for covered professional services furnished by a MIPS eligible clinician in 2021. MIPS eligible clinicians, groups, and virtual groups (along with their designated support staff or authorized third-party intermediary), including APM participants, may request the Centers for Medicare & Medicaid Services (CMS) to review the calculation of their 2020 MIPS payment adjustment factor(s) through a process called targeted review. The deadline to submit your request is Oct. 5, 8 p.m…. . . . read more.

QPP

2019 MIPS performance feedback and final score available now

The Centers for Medicare & Medicare Services (CMS) has released 2019 Merit-based Incentive Payment System (MIPS) performance feedback and final scores. If you submitted data for the 2019 performance period, you can view your MIPS performance feedback and final score on the Quality Payment Program website. You can access your 2019 MIPS performance feedback and final score by: Going to cms.gov/login Logging in using your HCQIS Access Roles and Profile (HARP) system credentials; these are the same credentials that allowed you to submit your 2019 MIPS data If you don’t have a HARP account, please refer to the Register for a HARP Account document in the QPP Access User Guide and start the process now. To learn more about performance feedback, review the 2019 MIPS Performance Feedback Resources: 2019 MIPS Performance Feedback FAQs—Highlights what performance… . . . 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.

CMS QPP

MIPS data submission deadline extended to April 30

The 2019 Merit-based Incentive Payment System (MIPS) data submission deadline has been extended by 30 days to April 30, 2020. In general, if you have already submitted MIPS data or if you submit MIPS data by April 30, 2020, you will be scored and receive a MIPS payment adjustment based on the data you submit. Many MIPS eligible clinicians have performed very well in the MIPS program in previous years, says the CMS. If you need to revise any data that has already been submitted you can still make changes by logging into qpp.cms.gov by the new deadline. 2019 MIPS Extreme and Uncontrollable Circumstances Policy Update MIPS eligible clinicians who have not submitted any MIPS data by April 30, 2020 do not need to take any additional action to qualify… . . . read more.

BILLING AND COLLECTIONS

CMS to launch new MIPS Participation Framework in 2021 Performance Period

CMS is implementing a new participation framework for the Merit-based Incentive Payment System (MIPS), called the MIPS Value Pathways (MVPs), starting with the 2021 performance period. The goal of this new framework is to move away from siloed performance category measures and activities, and move toward an aligned set of measures and activities that are more meaningful to clinicians and patient care. With the MVPs framework, CMS is aiming to connect measures and activities across the Quality, Cost, Promoting Interoperability, and Improvement Activities performance categories of MIPS for different specialties and conditions. The new framework is designed to: Simplify MIPS and reduce clinician burden; Improve value and create a more cohesive and meaningful participation experience; and Better align with Alternative Payment Models (APMs) to help ease the transition from MIPS… . . . read more.

QUALITY PAYMENT PROGRAM

MIPS 2020 payment adjustments in effect based on 2018 performance

In July 2019, each Merit-based Incentive Payment System (MIPS) eligible clinician received a 2018 MIPS Final Score and associated payment adjustment factor(s) as part of their 2018 MIPS performance feedback, available on the Quality Payment Program website. 2020 MIPS payment adjustments, based on each MIPS eligible clinician’s 2018 MIPS final score, will now be applied to payments made for Part B covered professional services payable under the Physician Fee Schedule. Payment adjustments are determined by the final score associated with your Taxpayer Identification Number (TIN)/National Provider Identifier (NPI) combination. MIPS eligible clinicians, identified by TIN/NPI combination for the 2018 performance period, will receive a positive, neutral, or negative MIPS payment adjustment in 2020 if they: Were a clinician type that was included in MIPS; Enrolled in Medicare prior to Jan…. . . . read more.


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