Monday Morning Rounds with CMS

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.

News

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

CMS Innovation Center