ICYMI, here is recent communication from CMS.
Events
Register for the 2023 MIPS Overview Webinar
When: Wednesday, April 26, 2023
Time: 1:30 – 3:00 pm ET
Register for this event.
CMS is hosting a series of Quality Payment Program (QPP) webinars to highlight the requirements for the Merit-based Incentive Payment System (MIPS) for the 2023 performance year. The first presentation providing an overview of traditional MIPS requirements for 2023 will be held this Wednesday. During the webinar, CMS subject matter experts will provide information on ways to participate in MIPS in 2023, including:
- MIPS eligibility requirements
- Participation requirements for traditional MIPS
- Requirements for participation in MIPS via the Alternative Payment Model (APM) Performance Pathway (APP)
Additionally, attendees can engage with CMS subject matter experts and ask questions, as time permits.
Please note that the session won’t include details about participating in MIPS via the MIPS Value Pathways (MVPs) for 2023. Learn more about implementing MVPs on the QPP website. CMS will provide more detailed information about the 2023 performance categories in subsequent webinars in the coming weeks. Stay tuned for additional details, including dates and how to register.
MIPS News
Reminder: 2023 MIPS Value Pathway (MVP) Registration is Open
The Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs) registration window is open for the 2023 performance year. Individuals, groups, subgroups, and Alternative Payment Model (APM) Entities that wish to report an MVP can register until November 30, 2023, at 8 p.m. ET. For the 2023 performance year, MVPs are a new, voluntary way to meet MIPS reporting requirements. Each MVP includes a subset of measures and activities that are related to a specialty or medical condition to offer more meaningful participation in MIPS.
- Visit Explore MVPs to review the available MVPs finalized for the 2023 performance year.
- Not sure how you’ll report for MIPS in 2023? You can learn more about the MVP reporting option on the QPP website.
We’ve updated our Merit-based Incentive Payment System complex patient bonus policies to better target clinicians with a higher share of medically and/or socially complex patients. Read our 2022 MIPS Complex Patient Bonus Fact Sheet to learn more: https://t.co/murOtILnO9 #QPP pic.twitter.com/kRVuZiyTCC
— CMSGov (@CMSGov) April 17, 2023
Are you participating in the Merit-based Incentive Payment System (#MIPS) as a group for the 2023 performance year? Check out our 2023 MIPS Group Participation
Guide for an overview of this data submission option: https://t.co/iH8J3tHfDI #QPP pic.twitter.com/wDp82VLNNI— CMSGov (@CMSGov) April 10, 2023
News
#ONCHTI1 is now open for public comment! We will make a public comment template available in the coming days. Please submit comments no later than 11:59 pm ET on June 20. https://t.co/jOMSxF6V6p pic.twitter.com/ozCZ6cgKfN
— ONC (@ONC_HealthIT) April 18, 2023
For the First Time, HHS Is Making Ownership Data for All Medicare-Certified Hospice and Home Health Agencies Publicly Available
The Biden-Harris Administration has made promoting competition and protecting consumers a top priority. In support of the President’s Executive Order on promoting competition and the Administration’s commitment to transparency, the U.S. Department of Health and Human Services (HHS) is releasing ownership data for all Medicare-certified hospice and home health agencies. For the first time, anyone can now review detailed information on the ownership of more than 6,000 hospices and 11,000 home health agencies certified to participate in the Medicare program on the Centers for Medicare & Medicaid Services (CMS) website.
APM Incentive Payment Extended through 2023
In December 2022, Congress enacted provisions of the Advanced Alternative Payment Model (APM) Consolidated Appropriations Act, 2023 that extended the availability of an APM Incentive Payment, allowing eligible clinicians who are Qualifying APM Participants (QPs) for the 2023 QP performance period to receive a 3.5% APM Incentive Payment in the 2025 payment year. Without this, there would have been a one-year gap with no statutory incentives for Advanced APM participation for the 2025 payment year.
Details Released on Medicare Advantage Value-Based Insurance Design (VBID) Model Extension
Under an extension through calendar years 2025 to 2030, the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model will introduce changes intended to more fully address the health-related social needs of patients, advance health equity, and improve care coordination for patients with serious illness. For more information on the changes to the model under the extension, please see our overview.
HHS Updates 2024 Medicare Advantage Program and Part D Payment Policies
The U.S. Department of Health and Human Services, through CMS, released the Calendar Year 2024 Medicare Advantage and Part D Rate Announcement that finalized payment policies for these programs. The final policies in the Rate Announcement improve payment accuracy and ensure taxpayer dollars are well spent. CMS will phase-in certain updates, and on average, CMS anticipates a payment increase for MA plans of 3.32% from 2023 to 2024, which is approximately a $13.8 billion increase in MA payments for next year.
CMS Proposes Policies to Improve Patient Safety and Promote Health Equity
CMS issued a proposed rule for inpatient and long-term care hospitals that builds on the Biden-Harris Administration’s key priorities to advance health equity and support underserved communities. As required by statute, the fiscal year (FY) 2024 inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) rule updates Medicare payments and policies for hospitals. The rule would also adopt hospital quality measures to foster safety, equity, and reduce preventable harm in the hospital setting. CMS is proposing to recognize homelessness as an indicator of increased resource utilization in the acute inpatient hospital setting, which may result in higher payment for certain hospital stays. This action aligns with the Administration’s goal of providing support to historically underserved and under-resourced communities.
Quality Payment Program
Have you submitted PY2022 data to the Quality Payment Program (QPP)? They want to hear from you!
Follow this link to take the survey!
The goal of this survey is to help CMS better understand the experiences of QPP participants who have submitted Performance Year (PY) 2022 data. Your responses will help CMS identify how the submissions process can be improved, as well as what’s working well. Results will be reported in such a way that no single individual, group, or entity can be identified. This survey is conducted by outside contractors, and participation is completely voluntary and confidential. Your decision to participate or not to participate in this survey will not affect any pending or future determinations. This survey should take no more than 15 minutes to complete.
Administrative Simplification
#HIPAA set national standards that work to reduce paperwork and streamline business communications across the health care system. Learn the basics of compliance by visiting the Administrative Simplification website: https://t.co/Xh2LIB2NX5 #AdminSimp pic.twitter.com/xlGVmItKHK
— CMSGov (@CMSGov) April 21, 2023
Need to determine whether you or your organization is subject to HIPAA’s Administrative Simplification provisions? Our interactive Covered Entity Decision Tool helps you figure out your status: https://t.co/UVQD97ctfD #HIPAA #AdminSimp pic.twitter.com/5htqHNTDDu
— CMSGov (@CMSGov) April 20, 2023
Stay up to date on important Administrative Simplification news and info. Sign up for our Email Updates here: https://t.co/eH8CjFYf63 #AdminSimp pic.twitter.com/APGlmTjUEi
— CMSGov (@CMSGov) March 31, 2023
MLN Matters Articles
- Medicare Home Health Prospective Payment System CY 2023: Materials from March Webinar
- New Waived Tests
- Hospital Outpatient Prospective Payment System: April 2023 Update — Revised
- Medicare Part B Coverage of Pneumococcal Vaccinations
- Supervision Requirements for Diagnostic Tests: Manual Update
- Ambulatory Surgical Center Payment System: April 2023 Update
- DMEPOS Fee Schedule: April 2023 Update
Claims, Pricers, & Codes
- Grandfathered Tribal Federally Qualified Health Centers: CY 2023 Rate
- Home Health Original Claims: Don’t Include Cross-Reference Document Control Numbers
- Outpatient Rehabilitation Claims with Reason Code W7072: You Might Need to Resubmit Claims
- RARCs, CARCs, Medicare Remit Easy Print, & PC Print: April Update
- COVID-19: Reporting CR Modifier & DR Condition Code After Public Health Emergency
- April 2023 Quarterly Pricing File Revisions
CMS Innovation Center
Save the date! Tune in to the Quarterly National Stakeholder Call on 4/25 to hear from Innovation Center Director @LizFowler_ & other CMS leadership about our recent accomplishments and progress on cross-cutting initiatives: https://t.co/fLhWHzj38j pic.twitter.com/BXsq8pj0MN
— CMS Innovation Ctr (@CMSinnovates) April 21, 2023
Missed the #personcenteredcare listening session last week? Check out the event slides, recording & transcript describing how we use #patient & #caregiver feedback to inform our work and strategy: https://t.co/PrtDrWmcLS pic.twitter.com/NkyFNNt9XH
— CMS Innovation Ctr (@CMSinnovates) April 19, 2023
#ICYMI 2024 applications for the Bundled Payments for Care Improvement Advanced Model are due by 5/31 at 5P EDT ⏰. Apply here: https://t.co/mZqtIXpsh1 pic.twitter.com/2sw9LjuVI4
— CMS Innovation Ctr (@CMSinnovates) April 18, 2023
#DYK in 2022, 2 million+ patients w/Dual Eligible Special Needs Plans received reduced Part D cost-sharing, AKA lower costs, through the Value-Based Insurance Design (VBID) Model? More patients are expected to receive reduced costs in 2023 through VBID: https://t.co/6B3MxfczFF pic.twitter.com/BPXVGJSecl
— CMS Innovation Ctr (@CMSinnovates) April 17, 2023