Monday Morning Rounds with CMS

ICYMI, here is recent communication from CMS.


Save the Date! 2022 VBID Hospice Benefit Component – Office Hours
When: Thursday, February 3, 2022  2:00 – 3:00 pm ET
Register for this event.
Event number: 2457 421 1948
Event password: officehours0203

The Value-Based Insurance Design (VBID) Model Team will host an office hours session on the Hospice Benefit Component to provide technical and operational support to interested stakeholders. During this office hour session, presenters will answer questions submitted in advance to the VBID Mailbox and also offer attendees an opportunity to ask additional questions.

Please submit questions in advance by emailing the VBID Mailbox at


CMS Seeking Recommendations for MIPS Specialty Measure Sets
CMS is accepting stakeholders’ recommendations regarding potential new specialty measure sets and/or revisions to existing specialty measure sets for the 2023 performance year of MIPS. Recommendations for new specialty sets or revisions to the 2022 specialty sets should be based on the established 2022 MIPS quality measures. Visit the Quality Payment Program (QPP) Resource Library to view the 2022 MIPS quality measure specifications. CMS specifically requests stakeholder feedback on applicable quality measures for the following specialty: Optometry.

Now Available: 2022 MIPS Quality Resources
CMS has posted new 2022 Merit-based Incentive Payment System (MIPS) resources related to the quality performance category to the QPP Resource Library.

Quality Payment Program

Participate in Field Testing of Cost Measures Now through February 25
Field testing is now live! CMS and its contractor, Acumen, LLC, are conducting field testing of 5 episode-based cost measures from January 10 to February 25, 2022. The following episode-based cost measures are currently being field tested before consideration of their potential use in the cost performance category of the Merit-based Incentive Payment System (MIPS) of the Quality Payment Program (QPP):

  • Emergency Medicine
  • Heart Failure
  • Low Back Pain
  • Major Depressive Disorder
  • Psychoses/Related Conditions

Clinicians and clinician groups who meet the attribution requirements for at least one of the measures will receive a Field Test Report. All stakeholders are invited to provide feedback on the draft measure specifications through an online survey, which closes on February 25, 2022, at 11:59 PM ET. Participation is voluntary.

QPP Participation Status Tool Now Includes Third Snapshot of 2021 Qualifying APM Participant and MIPS APMs Data
CMS updated its Quality Payment Program Participation Status Lookup Tool based on the third snapshot of data from Alternative Payment Model (APM) entities.

The third snapshot includes data from Medicare Part B claims with dates of service between January 1, 2021 and August 31, 2021. The tool includes 2021 Qualifying APM Participant (QP) and Merit-based Incentive Payment System (MIPS) APM participation status.

MIPS 2021 Data Submission Period is Now Open
CMS has opened the data submission period for Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in the 2021 performance year of the Quality Payment Program (QPP). Data can be submitted and updated from now until 8:00 p.m. ET on March 31, 2022.

2022 MIPS Payment Adjustments in Effect Based on 2020 Performance
In Summer 2021, each Merit-based Incentive Payment System (MIPS) eligible clinician received a 2020 MIPS final score and associated payment adjustment factor(s) as part of their 2020 MIPS performance feedback, available on the Quality Payment Program website.

QPP Service Center Hold Times Expected to Increase
The Quality Payment Program (QPP) Service Center is projecting an increase in volume of calls and emails between January and March 2022 due to the opening of 2021 MIPS data submission period. The increase in call volume and emails will result in longer wait times.

Promoting Interoperability

The Deadline to Register and Attest for the CY 2021 Medicare Promoting Interoperability Program for Eligible Hospitals and Critical Access Hospitals is March 31, 2022
The deadline to register and attest for the calendar year (CY) 2021 EHR reporting year for CMS Medicare Promoting Interoperability Program is March 31, 2022 at 11:59 p.m. ET. Program participants from eligible hospitals and critical access hospitals (CAHs) are required to attest through CMS’s Hospital Quality Reporting system (previously, the QualityNet Secure Portal).

“Medicare and Medicaid Promoting Interoperability Programs” becomes “Medicare Promoting Interoperability Program for eligible hospitals and CAHs” after ending of Medicaid Promoting Interoperability Program
With the Medicaid Promoting Interoperability Program ending in program year 2021, CMS has changed the Medicare and Medicaid Promoting Interoperability Programs name to the Medicare Promoting Interoperability Program for eligible hospitals and CAHs.” Previously, information distributed under the Promoting Interoperability Programs listserv was for participants of either program. Moving forward, information distributed through this listserv will be only relevant for eligible hospitals and critical access hospitals participating in the Medicare Promoting Interoperability Program.

Administrative Simplification

HIPAA Covered Entity Decision Tool
Did you know that HIPAA (Health Insurance Portability and Accountability Act)-covered entities must also comply with standards for electronic transactions – not just privacy and security provisions? The Centers for Medicare & Medicaid Services (CMS) offers a tool to help health care providers and organizations check whether or not they are considered HIPAA-covered entities.

Visit the CMS Administrative Simplification website to learn about the standards and operating rules that are required for electronic health care transactions conducted by HIPAA-covered entities.

CMS Innovation Center

Announced: BPCI Advanced
The Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model is a new iteration of CMS and the Innovation Center continuing efforts in implementing voluntary episode payment models. The Model aims to support healthcare providers who invest in practice innovation and care redesign to better coordinate care and reduce expenditures, while improving the quality of care for Medicare beneficiaries. BPCI Advanced qualifies as an Advanced Alternative Payment Model (APM) under the Quality Payment Program.

Announced: Comprehensive ESRD Care Model
The Comprehensive ESRD Care (CEC) Model was designed to identify, test, and evaluate new ways to improve care for Medicare beneficiaries with End-Stage Renal Disease (ESRD). Through the CEC Model, CMS partnered with health care providers and suppliers to test the effectiveness of a new payment and service delivery model in providing beneficiaries with person-centered, high-quality care. The Model built on Accountable Care Organization experience from the Pioneer ACO Model, Next Generation ACO Model, and the Medicare Shared Savings Program to test Accountable Care Organizations for ESRD beneficiaries.