New Resources Available on QPP Resource Library

The Centers for Medicare and Medicaid Services (CMS) has posted the following new resources to the Quality Payment Program (QPP) Resource Library:

Participating in QPP in 2019 Infographic – Describes how to check your QPP participation status; basic requirements for participating in the Merit-based Incentive Payment System (MIPS), Advanced Alternative Payment Models (APMs), and MIPS APMs; and key dates for 2019 participation.
2019 MIPS Eligibility Decision Tree – Uses a series of questions to help clinicians determine if they are eligible for MIPS in 2019 based on factors such as clinician type, when they enrolled in Medicare, and the low-volume threshold.
2019 MIPS Specialty Guides – Highlights specific MIPS measures and activities that may apply to the following specialties: clinical psychologists, physical therapists and occupational therapists, speech-language pathologists and audiologists, registered dietitian and nutrition professionals, anesthesiologists and certified nurse anesthetists, and primary care clinicians.
2018 MIPS Eligibility Redetermination Fact Sheet – Provides information for practices with clinicians that started billing under the TIN between September 1, 2018 and December 31, 2018, and for practices with MIPS eligible clinicians who left the practice during the 2018 performance year.
2019 CAHPS for MIPS Approved Survey Vendors – Lists the survey vendors CMS has approved to administer the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) for MIPS survey for 2019

2019 MIPS Quality User Guide - This guide details how to participate in the Quality performance category of MIPS in 2019.

2019 MIPS Cost User Guide - This guide details how to participate in the Cost performance category of MIPS in 2019.

For More Information

Visit the Quality Payment Program Resource Library for more Quality Payment Program resources. Check the QPP Participation Status Tool for initial eligibility information.

Questions? Contact your local technical assistance organization or the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292 (TTY: 1-877-715-6222).

New Eligibility Developer Resources Available for the Quality Payment Program

The Quality Payment Program (QPP) is creating more ways for developers to build software that integrates directly with CMS applications and data. As part of that initiative, the Quality Payment Program Developer Tools now includes information on how to programmatically interact with eligibility data via the Eligibility Application Programming Interface (API). The public-facing Eligibility API is built using GraphQL, which allows developers to flexibility query data on clinicians and their associated practices, virtual groups, and APM entities.

Visit the Developer Tools page for information on all of the QPP integrations, including the new Eligibility API resource.

This API is still in early development stages. CMS would appreciate your feedback on the API and associated documentation via the Developer Support Google Group.

Developers can interact with one another in this Google Group to ask questions, find answers, and share experiences using these APIs. Please join this group to stay up-to-date with the latest QPP API releases.

Patients Over Paperwork Initiative Update

Last week, CMS issued a Request for Information (RFI) seeking new ideas from the public on how to continue the progress of the Patients over Paperwork initiative. Since launching in fall 2017, Patients over Paperwork has streamlined regulations to significantly cut the “red tape” that weighs down our healthcare system and takes clinicians away from their primary mission—caring for patients. As of January 2019, CMS estimates that through regulatory reform alone, the healthcare system will save an estimated 40 million hours and $5.7 billion through 2021. These estimated savings come from both final and proposed rules.

The RFI on Reducing Administrative Burden to Put Patients over Paperwork invites patients and their families, the medical community, and other healthcare stakeholders to recommend further changes to rules, policies, and procedures that would shift more of clinicians’ time and our healthcare system’s resources from needless paperwork to high-quality care that improves patient health.

Yesterday’s RFI provides an opportunity for you to share new ideas not conveyed during the first Patients over Paperwork RFI in 2017 and continue the conversation on improving healthcare delivery. We are seeking innovative ideas that broaden perspectives on potential solutions to relieve burden and ways to improve:

Reporting and documentation requirements
Coding and documentation requirements for Medicare or Medicaid payment
Prior authorization procedures
Policies and requirements for rural providers, clinicians, and beneficiaries
Policies and requirements for dually enrolled (i.e., Medicare and Medicaid) beneficiaries
Beneficiary enrollment and eligibility determination
CMS processes for issuing regulations and policies

More Information on the RFI on Reducing Administrative Burden to Put Patients over Paperwork

The RFI on Reducing Administrative Burden to Put Patients over Paperwork is posted in the Federal Register at: https://www.federalregister.gov/documents/2019/06/11/2019-12215/request-for-information-reducing-administrative-burden-to-put-patients-over-paperwork

Comments must be submitted by August 12, 2019.

The Press Release can be accessed here: https://cms.gov/newsroom/press-releases/cms-seeks-public-input-patients-over-paperwork-initiative-further-reduce-administrative-regulatory

More information on the Patients over Paperwork initiative is available at: https://www.cms.gov/about-cms/story-page/patients-over-paperwork.html

Sign up for the Patients over Paperwork Newsletter here: https://public.govdelivery.com/accounts/USCMS/subscriber/new?topic_id=USCMS_12350