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:

2018 Targeted Review User Guide – Helps those who are requesting CMS to review their 2020 Merit-based Incentive Payment System (MIPS) payment adjustment. This guide provides an overview of the targeted review process and lists steps to access and complete the Targeted Review Request Form.

For more information on the 2018 Targeted Review request process, reference the 2018 Targeted Review FAQs.

MIPS Data Validation and Audit Overview – Offers an overview of the MIPS data validation and audit process that will be conducted in 2019 for the 2017 and 2018 performance years, detailing how to select MIPS participants for data validation, which MIPS performance measures and activities will be included, and associated timelines.

See the 2017 MIPS Data Validation Criteria and 2018 MIPS Data Validation Criteria for a list of the criteria used to audit and validate the data submitted in each performance category.

MIPS Data Validation File Upload Instructions Video – Walks viewers through the process of securely uploading and submitting a MIPS Data Validation File to CMS.
Complex Patient Bonus Fact Sheet – Provides an overview of the complex patient bonus and explains bonus eligibility requirements and how the bonus is determined and calculated.
2019 QPP Clinician Role Demo Video – Demonstrates the steps to add the QPP clinician role, which allows clinicians to view their MIPS eligibility details, performance feedback, and payment adjustment without having to request access and wait for approval.

For more information on adding the new role or accessing the QPP portal, review the QPP Access User Guide.

Learn More

For additional information, visit the QPP website and QPP Resource Library.

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).

Quality Payment Program Exception Applications Available on QPP.CMS.GOV

The 2019 Quality Payment Program (QPP) Exception Applications for the Promoting Interoperability (PI) performance category and Extreme and Uncontrollable Circumstances for the Merit-based Incentive Payment System (MIPS) are now available on the QPP website.

Promoting Interoperability Hardship Exceptions

If you are participating in MIPS during the 2019 performance year as an individual, group, or virtual group – or participating in a MIPS Alternative Payment Model (APM) – you can submit a QPP Hardship Exception Application for the PI performance category, citing one of the following specified reasons for review and approval:

You’re a small practice
You have de-certified EHR technology
You have insufficient internet connectivity
You face extreme and uncontrollable circumstances
You lack control over the availability of certified electronic health record technology (CEHRT)

An approved QPP 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. If you’re already exempt from PI reporting, you do not need to apply for this exception.

You must submit a hardship exception application by December 31, 2019 for CMS to reweight the PI performance category to 0 percent. You will be notified by email if your request was approved or denied. Approval will be added to your eligibility profile in the QPP Participation Status Tool.

Note, MIPS eligible clinicians and Taxpayer Identification Numbers (TINs) participating in a MIPS APM do not need to report data for the PI performance category if they qualify for automatic reweighting or have an approved hardship exception. However, these clinicians will receive the APM entity score for Promoting Interoperability as determined by the APM scoring standard if the performance category is not reweighted for the entire entity.

Extreme and Uncontrollable Circumstances

MIPS eligible clinicians who are impacted by extreme and uncontrollable circumstances may submit a request for reweighting the Quality, Cost, and Improvement Activities performance categories.

“Extreme and uncontrollable circumstances” are defined as rare events entirely outside of your control and the control of the facility in which you practice.

These extreme and uncontrollable circumstances would cause you to either be:

Unable to collect information necessary to submit for a performance category, OR
Unable submit information that would be used to score a performance category for an extended period (for example, if you were unable to collect data for the Quality performance category for 3 months).

The automatic extreme and uncontrollable circumstances policy applies to MIPS eligible clinicians located in a CMS-designated region that’s been affected by an extreme and uncontrollable event, such as a FEMA-related major disaster, during the 2019 MIPS performance period. Affected MIPS eligible clinicians will have all four performance categories reweighted to 0 percent of their final scores unless they submit data for two or more performance categories.

The application for extreme and uncontrollable circumstances must be submitted by December 31, 2019 for the 2019 MIPS performance year. You will be notified by email if your request was approved or denied. Approval will be added to your eligibility profile in the QPP Participation Status Tool.

For More Information:

To learn more about QPP, visit the QPP website, QPP Resource Library, and QPP Webinar Library.

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).

The 2019 Quality Payment Program API Developer Preview is Now Open

The Quality Payment Program (QPP) Application Programming Interface (API) Developer Preview environment is now open for testing QPP submissions for performance year 2019

What is the Developer Preview?

The Developer Preview is a testing environment that allows third party software developers to integrate with various QPP Application Programming Interfaces (APIs) and test their development work prior to the submissions window.

Which QPP APIs are available in the Developer Preview?

The QPP Submissions API and CMS Web Interface API are now available in this testing environment. For more information about these APIs, please visit our Developer Tools,

https://qpp.cms.gov/developers.

Who Can Use the QPP APIs?

The Submissions API is available to Qualified Registries, Qualified Clinical Data Registries (QCDRs), and EHR vendors and developers.
The CMS Web Interface API is available to developers supporting ACOs or the groups and virtual groups who are registered to report through the CMS Web Interface.

What's New to the Developer Preview in 2019?

QPP has added “Oauth2” as an additional authentication protocol to the Submissions API. This feature will enable EHR applications to report data to QPP using the Submissions API, beginning with the 2019 performance year. For more information about how to get started using Oauth and registering your application in the Developer Preview environment, please visit our Developer Documentation. https://cmsgov.github.io/qpp-submissions-docs/.

The authentication protocol for Qualified Registries and QCDRs has not changed with the addition of Oauth. Developer Preview tokens are now available for these organizations when you sign in to qpp.cms.gov. You need to have the security official role to retrieve the Developer Preview token for your organization.

Learn More

For more detailed information about updates to the Submissions API and Web Interface API, please refer to their Developer Documentation, https://qpp.cms.gov/developers.

For questions and assistance, please join our Developer Google Group for QPP APIs, https://groups.google.com/forum/#!forum/qpp-apis.

For specific questions regarding the CMS Web Interface API, please join our Developer Google Group for the CMS Web Interface API, https://groups.google.com/forum/#!forum/cms-web-interface.

For additional information on QPP access and the Security Official role, please review the Quality Payment Program Access User Guide on the QPP Resource Library, https://qpp-cm-prod-content.s3.amazonaws.com/uploads/335/QPP+Access+User+Guide.zip.

You may also contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292 (TTY: 1-877-715-6222).