Medicare Compliance & Reimbursement

Plus: Heed new MAC guidance on MBIs.

The window is now open for eligible clinicians to submit their 2018 Quality Payment Program (QPP) data, but CMS changed to a new program for submissions late in December.

Change: “CMS is transitioning the system used to create identity management accounts and request access to the QPP website from the Enterprise Identity Data Management System (EIDM) to the HCQIS Access Roles and Profile System (HARP),” said CMS in a release on the change. “All users will manage access to the organizations they represent for reporting quality data and viewing their MIPS feedback directly through the QPP website.”

If you already have an EIDM user name and password, you’ll be using that information to access your QPP data. However, if you don’t, you’ll need to register for a HARP account to review your data and send submission.

Access the HARP registration at https://qpp.cms.gov/login?page=register.

In other news…

As CMS finishes up its new Medicare card distribution to existing beneficiaries, providers still have until next January 2020 to switch to using the new Medicare Beneficiary Identifier (MBI) number instead of the old Social Security Number-based Health Insurance Claim Number (HICN).

Until Dec. 31, 2019, CMS “will offer a transition period during which the system will accept both HICNs and MBIs on Medicare transactions (including eligibility requests and claims) for beneficiaries in the Medicare program prior to April 1, 2018 (i.e., those who received a HICN on their Medicare card),” MAC Palmetto GBA notes in a new article on its website.

Warning: However, “providers should not submit both numbers on the same transaction,” Palmetto stresses.

Providers also shouldn’t use the grace period to continue an old shortcut — submitting claims with just the patient’s Social Security Number with an “A” suffix. “This has caused thousands of claims to reject,” criticizes MAC CGS in a new article on its website. “As you know, rejected services are a huge time-waster for you because you have to handle the claim a second time, fix it, then resubmit for processing.”

Keep in mind: “A patient may have Medicare benefits under a spouse or parent; therefore, the … HICN may not include the social security number of the patient being treated,” CGS reminds.