Monday Morning Rounds with CMS

ICYMI, here is recent communication from CMS.


Reminder: The 2023 Merit-based Incentive Payment System (MIPS) Self-Nomination Closes on September 1
CMS would like to remind you that the end of the 2023 MIPS Self-Nomination for Qualified Clinical Data Registries and Qualified Registries is September 1, 2022, at 8 p.m. ET. The Self-Nomination form on the Quality Payment Program website will lock at the deadline, and users won’t be able to make additional edits. Please ensure that your 2023 MIPS Self-Nomination form is complete and then click the Submit for Review button on the QPP website before the deadline.

Submit Comments on Policy Changes for Quality Payment Program in 2023 Physician Fee Schedule Proposed Rule
CMS recently issued its proposed policies for the 2023 performance year of the Quality Payment Program via the Medicare Physician Fee Schedule Notice of Proposed Rule Making. The deadline to submit formal comments on the proposed rule is September 6, 2022.

How To Submit Your Formal Comment(s)

You must officially submit your comments in one of the following ways:

  • Electronically (due no later than 11:59 p.m. ET on September 6, 2022)
  • Mailed (due no later than 5 p.m. ET on September 6, 2022)
    • Regular mail
    • Express or overnight mail
    • Hand or courier

Nomination Period Open for Clinician Expert Workgroups for MACRA Cost Measure Comprehensive Reevaluation
CMS and its contractor, Acumen, LLC, are seeking nominations for the Clinician Expert Workgroups that will be reconvened to provide input on the comprehensive reevaluation of 3 episode-based cost measures (EBCMs) first used in the Quality Payment Program (QPP) in the 2019 performance year. Stakeholders are invited to submit nominations through September 9, 2022, at 11:59 p.m. ET.


CMS Releases Proposed Rule to Improve Medicaid & CHIP Quality Reporting Across States
CMS released a notice of proposed rulemaking to promote consistent use of nationally standardized quality measures in Medicaid and the Children’s Health Insurance Program (CHIP). This will help identify gaps and health disparities among the millions of people enrolled in these programs.

CMS Discontinuing the Use of Certificates of Medical Necessity and Durable Medical Equipment Information Forms
As part of its ongoing efforts to increase access to care and to reduce unnecessary administrative burden for stakeholders, CMS will be discontinuing the use of Certificates of Medical Necessity (CMNs) and Durable Medical Equipment (DME) Information Forms (DIFs) for claims with dates of service on or after January 1, 2023. CMS suppliers must continue to submit CMN and DIF information for claims with dates of service before January 1, 2023 if it is required.

Learn About Changes to the Medicare Promoting Interoperability Program for 2023
On August 1, 2022, CMS issued the Fiscal Year 2023 Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System (PPS) Final Rule. Final changes to the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals include the following…

Performance Period 2022 Eligible Clinician Electronic Clinical Quality Measure Education and Outreach Webinar Series
CMS developed and published webinar content from the Performance Period 2022 Eligible Clinician Electronic Clinical Quality Measure Education and Outreach Webinar Series. PDF slides and links to the webinar video recordings are available to review on the eCQI Resource Center (under “Get Started with eCQMs – Implementing eCQMs Eligible Clinicians”).

Quality Payment Program

MIPS Automatic Extreme and Uncontrollable Circumstances Policy Applied for Parts of Kentucky
In response to the Federal Emergency Management Agency designation of the recent Kentucky severe storms, flooding, landslides, and mudslides as a major disaster and the Secretary of Health and Human Services determination that a public health emergency exists for certain counties in Kentucky, the Centers for Medicare & Medicaid Services has determined that the Merit-based Incentive Payment System automatic extreme and uncontrollable circumstances policy will apply to MIPS eligible clinicians in designated areas of Kentucky.

Now Available: 2021 MIPS Performance Feedback, 2021 MIPS Final Score, and 2023 MIPS Payment Adjustment Information
CMS has released Merit-based Incentive Payment System (MIPS) performance feedback and final scores for the 2021 performance year and associated MIPS payment adjustment information for the 2023 payment year. You can view your 2021 MIPS performance feedback, including your final score and 2023 payment adjustment on the Quality Payment Program website.

Now Available: 2023 Eligible Clinicians and Eligible Hospitals/Critical Access Hospitals Electronic Clinical Quality Measure Flows
CMS developed and published the 2023 electronic clinical quality measure flows to the eCQI Resource Center. The eCQM flows supplement eCQM specifications for the 2023 reporting period for Eligible Hospitals/Critical Access Hospitals, and the 2023 performance period for Eligible Clinicians. The eCQM flows are designed to assist in interpretation of the eCQM logic and calculation methodology for performance rates. The eCQM flows provide an overview of each of the population criteria components and associated data elements that lead to the inclusion or exclusions into the eCQM’s quality action (numerator).

Promoting Interoperability

The Medicare Promoting Interoperability Program Hardship Exception Application for Eligible Hospitals and Critical Access Hospitals is Now Available
On May 1, CMS opened the Hardship Exception Application period for eligible hospitals and critical access hospitals that participated in the Medicare Promoting Interoperability Program in Calendar Year 2021. For the CY 2021 reporting period, CMS required that all eligible hospitals and CAHs use (1) existing 2015 Edition certification criteria, (2) the 2015 Edition Cures Update criteria, or (3) a combination of the two in order to successfully meet the program requirements, as finalized in the CY 2021 Physician Fee Schedule final rule (85 FR 84818 through 84828). CMS mandates that downward payment adjustments be applied to eligible hospitals and CAHs that were not meaningful users of CEHRT and score below the 50-point minimum requirement and failed to report two self-selected calendar quarters of eCQMs data on four self-selected eCQMs.

Administrative Simplification

CMS Innovation Center

CMMI Model Data Sharing (CMDS) Initiative Makes Model Participation Data Available to Researchers
CMS is pleased to announce the availability of new Research Identifiable Files (RIFs) for six CMS Innovation Center models.

CMS is releasing participation data for the following models: