Reminder: Submit MIPS 2019 Data by April 30, 2020

One Week Left to Submit Data for the 2019 MIPS Performance Period

The data submission deadline for Merit-based Incentive Payment System (MIPS) eligible clinicians participating in the 2019 performance period of the Quality Payment Program (QPP) is 1 week away. Data can be submitted and updated any time until 8:00 p.m. ET on April 30, 2020.

QPP Flexibilities: 2019 Novel Coronavirus (COVID-19) Response

For the MIPS 2019 performance period, CMS added flexibilities to allow the healthcare delivery system to focus on the 2019 Novel Coronavirus (COVID-19) response.

Individual MIPS eligible clinicians who are not able to submit any MIPS data by April 30, 2020 will qualify for the automatic extreme and uncontrollable circumstances policy and receive a neutral payment adjustment for the 2021 MIPS payment year.
MIPS eligible clinicians, groups, and virtual groups, including those not able to complete their 2019 MIPS data submission, can still apply for a 2019 extreme and uncontrollable circumstances exception. Applications can be submitted until 8:00 p.m. ET on April 30, 2020.

Review the Quality Payment Program COVID-19 Response Fact Sheet for more information on these added flexibilities.

How to Submit or Review Your 2019 MIPS Data

Go to the Quality Payment Program website
Sign in using your QPP access credentials
1. If you aren’t registered in the HCQIS Authorization Roles and Profile (HARP) system, refer to the QPP Access User Guide.
Submit or review your MIPS data for the 2019 performance period, including data reported on your behalf by a third party.

If you are not sure if you are eligible to participate in the Quality Payment Program, check your final eligibility status using the QPP Participation Status Lookup Tool. Clinicians and groups that are opt-in eligible need to make an election before they can submit data. (No election is required for those who don’t want to participate in MIPS.)

Small Practices & Medicare Part B Claims Measures

Clinicians in small practices who have been reporting Medicare Part B claims measures throughout the 2019 performance period have received Quality performance category scores at the individual and group level.

If your small practice has a group Quality score and is not able to, or did not intend to submit group data for additional performance categories, you should submit an extreme and uncontrollable circumstances application on behalf of the group to reweight all four performance categories.

Sign in to qpp.cms.gov for your preliminary feedback on Part B claims measure data processed to date. We’ll update this feedback at the end of the submission period with claims processed by your Medicare Administrative Contractor within the 60 day run out period.

Small, Underserved, and Rural Practice Support

Clinicians in small practices (including those in rural locations), health professional shortage areas, and medically underserved areas may request technical assistance from organizations that can provide no-cost support. To learn more about this support, or to connect with your local technical assistance organization, we encourage you to visit our Small, Underserved, and Rural Practices page on the Quality Payment Program website.

For More Information

To learn more about how to submit data, please review the 2019 Data Submission FAQs and other resources available in the QPP Resource Library.
Watch our series of data submission demo videos:

Questions?

Please contact the Quality Payment Program at 1-866-288-8292, Monday through Friday, 8:00 AM-8:00 PM ET or by e-mail at: QPP@cms.hhs.gov. To receive assistance more quickly, consider calling during non-peak hours—before 10 AM and after 2 PM ET.

Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

Daily COVID-19 News Alert

Here is a summary of recent Centers for Medicare & Medicaid Services (CMS) actions taken in response to the 2019 Novel Coronavirus (COVID-19), as part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, click here www.coronavirus.gov. For information specific to CMS, please visit the CMS News Room and Current Emergencies Website. CMS updates these resources on an ongoing basis throughout the day; the information below is current as of April 23, 2020 at 10:00 a.m.

CMS Issues Guidance Allowing Independent Freestanding Emergency Departments to Provide Care to Medicare and Medicaid Beneficiaries during the COVID-19 Public Health Emergency

CMS issued critical guidance allowing licensed, independent freestanding emergency departments (IFEDs) in Colorado, Delaware, Rhode Island, and Texas to temporarily provide care to Medicare and Medicaid patients to address any surge resulting from COVID-19. This action by the Trump Administration increases hospital capacity to ensure these states can quickly and effectively care for their most vulnerable citizens. Current law does not recognize IFEDs as a certified Medicare provider, meaning they cannot bill Medicare and Medicaid for services. However, during this public health emergency, these entities can be temporarily certified as a hospital to increase healthcare system capacity as part of each state’s pandemic plan.

Press Release

Trump Administration Launches New Toolkit to Help States Navigate COVID-19 Health Workforce Challenges

CMS and the Assistant Secretary of Preparedness and Response (ASPR) released a new toolkit to help state and local healthcare decision makers maximize workforce flexibilities when confronting COVID-19 in their communities. Developed by the Healthcare Resilience Task Force as part of the unified government’s response to COVID-19, the toolkit includes a full suite of available resources such as information on funding flexibilities, liability protections, and workforce training, to maximize responsiveness based on state and local needs. For example, state and local communities will be able to see how and where workforce waivers can be applied based on information from other areas. The resource builds on the Trump Administration’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported.

Press Release

Toolkit

Compliance Flexibilities Announced for Implementation of Interoperability Final Rules Due to COVID-19

In response to the COVID-19 public health emergency, CMS and the Office of the National Coordinator for Health IT (ONC), in conjunction with the HHS Office of Inspector General (OIG), announced a policy of enforcement discretion to allow compliance flexibilities regarding the implementation of the interoperability final rules announced on March 9, 2020. ONC, CMS, and OIG will continue to monitor the implementation landscape to determine if further action is needed.

Press Release

Updated Guidance Available for Plan Issuers on Prior Authorization, CARES Act Implementation

CMS issued guidance to issuers of individual, small group, Medicare Advantage, and Part D plans, addressing the flexibilities available related to utilization management and prior authorization during the COVID-19 public health emergency. New guidance for individual and small group health plans encourages issuers to utilize flexibilities related to utilization management processes, as permitted by state law, to ensure that staff at hospitals, clinics, and pharmacies can focus on care delivery and ensure that patients do not experience care delays.

Updated guidance for Medicare Advantage and Part D plans allows them to implement a number of additional flexibilities to support efforts that can help curb the spread of the virus and to help ensure MA and Part D enrollees do not experience disruptions in care or disruptions in pharmacy and prescription drug access. The guidance also implements important provisions of the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security (CARES) Act regarding coverage for COVID-19 testing and testing related services.

Individual and Small Group Plan Guidance

Medicare Advantage and Part D Plan Guidance

CMS Releases Additional Waivers for Long-Term Care Hospitals, Rural Health Clinics, Federally Qualified Health Centers and Intermediate Care Facilities

CMS continues to release waivers for the healthcare community that provide the flexibilities needed to take care of patients during the COVID-19 public health emergency. CMS recently provided additional blanket waivers related to caring for patients in Long-Term Care Hospitals (LTCHs), temporary expansion locations of Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), staffing and training modifications in Intermediate Care Facilities for individuals with intellectual disabilities, and the limit for substitute billing arrangements (locum tenens).

Guidance

CMS Gives States Additional Flexibility to Address Coronavirus Pandemic

CMS approved its first Medicaid COVID-19 emergency demonstration, making the state of Washington the first to receive approval. The approval provides new flexibility and resources so the state of Washington can deliver the most effective care to their Medicaid beneficiaries. In addition to new payment and reimbursement arrangements, the demonstration allows the state to target services based on geography and population needs and to triage access to long-term services and supports (LTSS) based on highest need.

To date, CMS has approved more than 115 requests for state relief in response to the COVID-19 pandemic, including recent approvals for Colorado, New York, Ohio, South Carolina, Washington, Wyoming, and Puerto Rico. These approvals help to ensure that states have the tools they need to combat COVID-19 through a wide variety of waivers, amendments, and Medicaid state plan flexibilities, including for programs that care for the elderly and people with disabilities. CMS developed a toolkit to expedite the application and review of each request and has approved these requests in record time. These approved flexibilities support President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported.

Section 1135 Waivers

Section 1115(a) Waivers

1915(c) Waiver Appendix K Amendments

Medicaid State Plan Amendments

CHIP State Plan Amendments