ICYMI, here is recent communication from CMS.
Reminder: Submit Comments on the 2021 Proposed Rule for the QPP Today – On August 3, CMS released its proposed policies for the 2021 performance year of the Quality Payment Program via the Medicare Physician Fee Schedule (PFS) Notice of Proposed Rulemaking (NPRM). CMS is seeking comment on a variety of proposals in the NPRM. Comments are due no later than 5 p.m. today.
Virtual Group Election Period for MIPS 2021 Performance Year Now Open – If you’re interested in forming a virtual group for the 2021 Merit-based Incentive Payment System (MIPS) performance year, the election period started October 1st. To form a virtual group, an election must be submitted to CMS via e-mail between October 1, 2020 and December 31, 2020 (11:59 p.m. ET). For further information regarding virtual group participation in MIPS, virtual group reporting requirements, the election process, checklists for virtual groups to consider, and sample templates, download the 2021 Virtual Group Toolkit.
QPP: 2020 MIPS Quality Measures Impacted by the Annual ICD-10 Coding Update – In the Calendar Year 2018 Quality Payment Program Final Rule (82 FR 53714 through 53716), CMS finalized the policy allowing for the review of quality measures for significant impacts due to ICD-10 coding changes during the performance period. Performance for these quality measures will be assessed based only on the first 9 months of the 12-month performance period. Additional information regarding this policy can be found in the 2020 MIPS Quality Measures Impacted by ICD-10 Updates located on the QPP Resource Library.
CMS Releases New Tools to Streamline Certification for Labs Testing for COVID-19 – CMS released new tools to reduce burdensome paperwork and authorization delays for laboratories seeking Clinical Laboratory Improvement Amendments (CLIA) certification to test for COVID-19. CMS’s quick-start guide helps laboratories with the application process for CLIA certification and includes information on the expedited review process implemented at the beginning of the public health emergency that allows labs to start COVID-19 testing before the official paper certificate arrives by postal mail. Laboratories also have a new option to pay CLIA certification fees on the CMS CLIA Program website. Online payments are processed overnight, which is substantially faster than hard-copy checks.
The Medicare Promoting Interoperability Program vs. MIPS Promoting Interoperability Performance Category – CMS has made significant strides in relieving regulatory burdens for providers; supporting the patient-doctor relationship in healthcare; and promoting transparency, flexibility, and innovation in the delivery of care. In recent years, to continue their commitment to promoting and prioritizing interoperability, CMS has made updates to their quality reporting programs to align with these goals. Check out the Fact Sheet.
CMS Issues Urgent Call to Action Following Drastic Decline in Care for Children in Medicaid and Children’s Health Insurance Program Due to COVID-19 Pandemic – CMS released preliminary Medicaid and CHIP data revealing that, during the coronavirus disease 2019 public health emergency, rates for vaccinations, primary, and preventive services among children in Medicaid and CHIP have steeply declined. This decline may have significant impacts on long-term health outcomes for children, as Medicaid and CHIP cover nearly 40 million children, including three quarters of children living in poverty and many with special health care needs that require health services.
The updated guidance is available on the Electronic Clinical Quality Improvement (eCQI) Resource Center.
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- 2020 Quality Reporting – Updated Telehealth Guidance for eCQMs on the Eligible Professionals and Eligible Clinicians page for the 2020 Performance Period.
- 2021 Quality Reporting – Updated Telehealth Guidance for eCQMs on the Eligible Professionals and Eligible Clinicians page for the 2021 Performance Period.
MLN Matter Articles
- Fiscal Year (FY) 2021 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) PPS Changes
- Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 27.0, Effective January 1, 2021
- Change to the Payment of Allogeneic Stem Cell Acquisition Services — Revised
- New Physician Specialty Code for Micrographic Dermatologic Surgery (MDS) and Adult Congenital Heart Disease (ACHD) and a New Supplier Specialty Code for Home Infusion Therapy Services — Revised
- October 2020 Update of the Ambulatory Surgical Center (ASC) Payment System — Revised
- October 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS) — Revised
- Penalty for Delayed Request for Anticipated Payment (RAP) Submission — Implementation — Revised
- Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment — Revised
- 2021 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update
- National Coverage Determination (NCD 90.2): Next Generation Sequencing (NGS) for Medicare Beneficiaries with Germline (Inherited) Cancer
- Update to the Medicare Claims Processing Manual
- Update to the Model Admission Questions for Providers to Ask Medicare Beneficiaries — Revised