Monday Morning Rounds with CMS

ICYMI, here is recent communication from CMS.


The CMS Innovation Center’s Approach to Person-Centered Care: Engaging with Beneficiaries, Measuring what Matters
When: Tuesday, September 20, 2022  3:30 – 4:30 pm ET
Register for this event.

The CMS Innovation Center (Innovation Center) will be hosting a webinar on the Center’s approach to testing models and innovations that support person-centered care. Liz Fowler, the Innovation Center Director, will provide opening and closing remarks. The webinar will cover the following topics:

  • How the “Strategy Refresh” is building a more person-centered health system
  • How Innovation Center model tests will incorporate patient perspectives across the life cycle of models to ensure patient needs are met
  • How patient-reported outcome measures will be leveraged in models to better measure patient experience and outcomes

Feedback Opportunity

QPP Feedback Opportunity: Tell them about your PY2021 Performance Feedback experience!
Have you viewed PY2021 Quality Payment Program Performance Feedback? They want to hear from you! The goal of this survey is to help CMS better understand the experiences of QPP participants who have logged on to view Performance Year 2021 Performance Feedback. Your responses will help CMS identify how current Performance Feedback can be improved, as well as what’s working well. Results will be reported in such a way that no single individual, group, or entity can be identified. This survey is conducted by outside contractors, and participation is completely voluntary and confidential. Your decision to participate or not to participate in this survey will not affect any pending or future determinations. This survey should take no more than 15 minutes to complete. Follow this link to take the survey!


Review the Updated Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals FAQ Page
CMS would like to spotlight the updated FAQ page on the Medicare Promoting Interoperability Program website. This page provides useful information and resources for Medicare Promoting Interoperability Program participants.

Medicare Shared Savings Program Saves Medicare More Than $1.6 Billion in 2021 and Continues to Deliver High-quality Care
CMS announced that the Medicare Shared Savings Program, through its work with Accountable Care Organizations – groups of doctors, hospitals and other health care providers — saved Medicare money while continuing to deliver high-quality care. Specifically, the program saved Medicare $1.66 billion in 2021 compared to spending targets. This marks the fifth consecutive year the program has generated overall savings and high-quality performance results.

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

Reminder: CMS Accepting 2021 MIPS Targeted Review Requests
If you participated in the Merit-based Incentive Payment System in 2021, you can now review your performance feedback, including your MIPS final score and payment adjustment factor(s), on the Quality Payment Program website. For MIPS eligible clinicians, your 2021 final score determines the payment adjustment you’ll receive in 2023, with a positive, negative, or neutral payment adjustment being applied to the Medicare paid amount for covered professional services furnished in 2023.

Now Available: 2022 Change Review Process (CRP)
CMS announces the availability of the 2022 Change Review Process for electronic clinical quality measures. The CRP provides eCQM users the opportunity to review and comment on draft changes to the eCQM specifications and supporting resources under consideration by the measure steward. The goal of the CRP is for eCQM implementers to comment on the potential impact of draft changes to eCQMs so CMS and measure stewards can make improvements to meet CMS’s intent of minimizing provider and vendor burden in the collection, capture, calculation, and reporting of eCQMs.

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).

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? 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