- New 2019 QPP Resources Available on QPP.CMS.GOV
- Reminder: MIPS Virtual Group Elections for 2019 are Due on December 31
- Reminder: Submit Your 2018 QPP Exception Applications by December 31
To help you prepare for the 2019 performance year of the Merit-based Incentive Payment System (MIPS), CMS has posted the following new resources to the Quality Payment Program Resource Library.
- 2019 Medicare Part B Claims Measure Specifications and Supporting Documents - Provides comprehensive descriptions of the 2019 claims measures for the MIPS Quality performance category.
- 2019 Clinical Quality Measure Specifications and Supporting Documents – Provides comprehensive descriptions of the 2019 clinical quality measures for the MIPS Quality performance category.
- 2019 CMS Web Interface Measure Specifications and Supporting Documents– Provides comprehensive descriptions of the 2019 CMS Web Interface measures for the MIPS Quality performance category.
- 2019 Cross-Cutting Quality Measures – Provides a list of 2019 cross-cutting Quality measures that are broadly applicable to all clinicians regardless of their specialty.
- 2019 Quality Measure Benchmarks – Lists and explains 2019 benchmarks used to assess performance in the Quality performance category.
- 2019 Promoting Interoperability Measure Specifications – Provides a detailed overview of the requirements for the 2019 Promoting Interoperability performance category objectives and measures.
- 2019 Cost Measure Code Lists – Details the cost measure code lists for each of the 8 episode-based cost measures that are new for the Cost performance category in 2019.
- 2019 Cost Measure Information Forms - Details the measure methodology for each of the 8 episode-based cost measures that are new for the Cost performance category in 2019 and provides an overview of the 2019 TPCC and MSPB cost measures that were established for the Merit-based Incentive Payment System (MIPS) in 2018.
- 2019 Merit-based Incentive Payment System (MIPS): Summary of Cost Measures- Provides a summary of cost measures in relation to MIPS.
- 2019 Improvement Activities Inventory – Provides a complete list of the 2019 improvement activities and includes descriptions for each.
- 2019 Qualified Clinical Data Registries (QCDRs) and Qualified RegistriesQualified Postings – Includes the list of CMS-approved QCDRs and Qualified Registries for MIPS in 2019, and the performance categories and measures they support.
- 2019 MIPS Participation and Eligibility Fact Sheet – Provides an overview of the eligibility criteria for participating in MIPS in 2019.
- 2019 Quality Performance Category Fact Sheet – Discusses the MIPS Quality performance category and includes an overview of quality measures and how to collect and submit quality data.
- 2019 Cost Performance Category Fact Sheet – Discusses the MIPS Cost performance category and provides details on the Total Per Capita Costs for All Attributed Beneficiaries measure (TPCC) and the Medicare Spending Per Beneficiary measure (MSPB), as well as the eight new episode-based measures.
For More Information:
- Visit the Quality Payment Program Resource Library for more Quality Payment Program resources.
- Go to the Quality Payment Program website to check your participation status, explore measures, and review guidance on MIPS, APMs, what to report, and more.
- Reach out to your local technical assistance organization.
- Contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292 (TTY: 1-877-715-6222).
If you’re interested in forming a virtual group for the 2019 Merit-based Incentive Payment System (MIPS) performance year, you must follow an election process and submit your election to CMS via e-mail by December 31, 2018. To learn more about the election process and how to participate in MIPS as a virtual group in 2019, view the 2019 Virtual Groups Toolkit.
- Contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292/TTY: 1-877-715-6222
- Reach out to your local technical assistance organization
CMS would like to remind you that the deadline for submitting 2018 Quality Payment Program Hardship Exception Applications for the MIPS Promoting Interoperability (PI) performance category and for Extreme and Uncontrollable Circumstances is December 31, 2018.
Promoting Interoperability Hardship Exceptions
If you’re participating in MIPS during the 2018 performance year as an individual, group, or virtual group—or participating in a MIPS Alternative Payment Model (APM)—you can submit a Quality Payment Program Hardship Exception Application for the PI performance category, citing one of the following specified reasons for review and approval:
- MIPS-eligible clinicians in small practices (new for 2018)
- MIPS-eligible clinicians using decertified EHR technology (new for 2018)
- Insufficient Internet connectivity
- Extreme and uncontrollable circumstances
- Lack of control over the availability of certified electronic health record technology (CEHRT)
An approved Quality Payment Program Hardship Exception will:
- Reweight your PI performance category score to 0 percent of the final score
- Reallocate the 25 percent weighting of the PI performance category to the Quality performance category
Please note that simply not using CEHRT does not qualify you for reweighting of your PI performance category. You must submit a hardship exception application by December 31, 2018 for CMS to reweight the PI performance category to 0 percent.
Extreme and Uncontrollable Circumstances
MIPS groups and virtual groups impacted by extreme and uncontrollable circumstances may submit a request for reweighting of the Quality, Cost, and Improvement Activities performance categories.
"Extreme and uncontrollable circumstances" are defined as rare events (highly unlikely to occur in a given year) entirely outside your control and the facility in which you practice.
These extreme and uncontrollable circumstances would cause you to be unable to collect information necessary to submit for a performance category, or to submit information that would be used to score a performance category for an extended period of time (for example, 3 months unable to collect data for the Quality performance category). In your application, you must indicate the performance categories that were subject to an extreme and uncontrollable circumstance and how the circumstance affected your group’s or virtual group’s ability to collect or submit data for the 2018 MIPS performance year.
The application for extreme and uncontrollable circumstances must be submitted by December 31, 2018 for the 2018 MIPS performance year.
Please note, if you’re participating in MIPS as an individual and are located in a CMS-designated region that has been affected by an extreme and uncontrollable event (such as FEMA-designated major disaster) during the 2018 performance year, you do not need to submit an application. You’re subject to the automatic extreme and uncontrollable circumstances policy. To learn more, view this fact sheet.
For More Information
- Review the 2018 QPP Hardship Exceptions FAQs
- Visit the Quality Payment Program Website
- Contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292/TTY: 1-877-715-6222.