Medicare Compliance & Reimbursement

With much of Medicare’s focus on COVID-19, you may have put your Quality Payment Program (QPP) quandaries on the backburner. But that doesn’t mean the feds have dropped the ball as they continue to churn out updates and request feedback on future initiatives.

Reminder: As part of its value-based programs, CMS uses eCQMs to digitally evaluate eligible providers’ quality measures, tracking clinical data via certified EHR technology (CEHRT). Not only does CMS factor in eCQM data when rewarding providers for positive quality outcomes, but it also utilizes the information to cut Medicare costs, reduce readmissions and medication errors, “drive clinical action,” and nix administrative burdens, QPP guidance indicates.

Check out the tracker and add your two cent by Jan. 24 at https://oncprojectracking.healthit.gov/support/projects/CQM/summary, review eCQM basics at www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/ClinicalQualityMeasures and find ONC insight at https://ecqi.healthit.gov/ecqms?qt-tabs_ecqm=4.

2. MIPS 2021 Data Submission Window Is Open

If you’ve got your Merit-Based Incentive Payment System (MIPS) PY 2021 measures in line — and you meet the eligibility requirements — you may start sending your data to CMS.

MIPS-eligible clinicians can submit PY 2021 information through March 31, 2022 by way of the QPP webpage at https://qpp.cms.gov/login. But remember, if you don’t already have a HCQIS Authorization Roles and Profile (HARP) account to submit MIPS measures, you’ll need to create one.

Important: Before you upload your MIPS files and hit send, you should verify that you meet the threshold requirements, says CMS in a QPP alert. “Clinicians who are not sure if they are eligible to participate in the Quality Payment Program can check their final eligibility status using the QPP Participation Status Tool. Clinicians and groups that are opt-in eligible will need to make an election before they can submit data.”

Election is only necessary for providers who opt-in and is not required if you or your organization doesn’t want to participate in MIPS.

3. Weigh In on MIPS Measures Sets

As the program evolves, CMS continues to request stakeholder feedback on existing measures but also on future ones. Currently, the agency is asking for specialty-focused input and revisions for PY 2022 as well as ideas for both implementation and modification of PY 2023 measures, a release suggests.

If you are interested in offering your opinion, “each recommendation must include the following in order to be considered,” according to CMS:

• Quality measure identifier (ID)
• Measure title
• Rationale and/or documentation that supports inclusion or exclusion of the current quality measure(s) from existing specialty measure sets or inclusion in new specialty measure sets

Find the QPP 2022 final rule and online guidance for a list of the specialities and measures sets at https://qpp.cms.gov/resources/resource-library.

“Submissions of recommendations will be accepted from stakeholders up until close of business on Monday, February 14, 2022,” the CMS alert advises.

4. Check Out SURS Support Before Program Ends

If you’ve relied on the QPP’s Small, Underserved, and Rural Support (SURS) initiative for MIPS set-up and submission advice, the agency is closing the program, according to online guidance.

Deadline: “As clinicians are preparing for the start of the 2022 performance year (PY), it is important to note that the SURS initiative will end on February 15, 2022 as the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) only provided for 5 years of direct support,” CMS says.

Review the details and access assistance at https://qpp.cms.gov/resources/small-underserved-rural-practices.

5. Get Involved With Cost Measures Field Testing

“CMS and its contractor, Acumen, LLC, are conducting field testing of 5 episode-based cost measures from January 10 to February 25, 2022,” mentions the agency in an alert. The MIPS episode-based cost measures that CMS is testing, according to the brief, include: emergency medicine; heart failure; lower back pain; major depressive disorder; and psychoses/related conditions.

All clinician types are welcome to weigh in on the cost measures, but only “clinicians and clinician groups who meet the attribution requirements for at least one of the measures will receive a Field Test Report,” the alert says.

Stakeholders can offer their feedback, which is not required and entirely voluntary, via online survey through Feb. 25 at https://acumen.qualtrics.com/jfe/form/SV_7VByoPD9BPTdR3w.