Monday Morning Rounds with CMS

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Posted By: HHS/ONC/CMS Communications May 23, 2022

ICYMI, here is recent communication from CMS.

Deadlines

Reminder: Submit Comments on Episode-Based Cost Measure Comprehensive Reevaluation through May 28, 2022
CMS and its contractor, Acumen, LLC, are currently gathering input on eight episode-based cost measures being considered for comprehensive reevaluation through a Call for Public Comment. This is a reminder that stakeholders are invited to submit their feedback by May 28, 2022, at 11:59 p.m. Eastern Time.

Provide Feedback on Proposed Changes to the Medicare Promoting Interoperability Program for Hospitals
On April 18, 2022, CMS issued the Fiscal Year 2023 Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Proposed Rule. Comments on the FY 2023 IPPS and LTCH PPS Proposed Rule are due no later than 5:00 p.m. ET, June 17, 2022. The public can submit comments in several ways: Electronically: Through the “submit a comment” instructions on the Federal Register; By regular mail; OR by express or overnight mail. Please review the proposed rule for specific instructions for each method and submit comments by one method only.

Register for the CMS Web Interface and the CAHPS for MIPS Survey Quality Reporting for the 2022 Performance Period by June 30, 2022
Registration is open for the CMS Web Interface and Consumer Assessment of Healthcare Providers and Systems (CAHPS) for the Merit-based Incentive Payment System (MIPS) Survey for the 2022 performance period.

  • Groups, virtual groups, and Alternative Payment Model (APM) Entities with 25 or more clinicians (including at least one MIPS eligible clinician) can register through June 30, 2022, to use the CMS Web Interface for reporting quality measures under traditional MIPS.
  • Groups, virtual groups, and APM Entities with 2 or more clinicians (including at least one MIPS eligible clinician) can register through 2022 to administer the CAHPS for MIPS Survey under traditional MIPS or the Alternative Payment Model (APM) Performance Pathway (APP).
  • Groups, virtual groups and APM Entities only need to register if they intend to report through the CMS Web Interface and/or administer the CAHPS for MIPS Survey for the 2022 performance period.

To register, please log in to the Quality Payment Program (QPP) website. You’ll need to have the Security Official role in order to register your organization. Please refer to the QPP Access User Guide (ZIP) for information about obtaining a Security Official role for your organization. You can register by:

  • Signing in to QPP.
  • Going to the Manage Access page.
  • Clicking “Edit Registration” by 8 p.m. ET on June 30, 2022.

News

CMS Unveils More User-Friendly Medicare Website
CMS unveiled several updates to the Medicare.gov website that make it easier, for millions of people who use it, to navigate and access information to compare and select health and drug coverage and find providers. The updated website, based on consumer feedback, prominently features timely initiatives and messages on the homepage and highlights key tasks and information most frequently sought by people with Medicare, people nearing Medicare eligibility, and their families.

CMS Now Accepting 2022 MIPS Extreme and Uncontrollable Circumstances Exception and MIPS Promoting Interoperability Performance Category Hardship Exception Applications
The MIPS Extreme and Uncontrollable Circumstances Exception and MIPS Promoting Interoperability Performance Category Hardship Exception applications are now open for the 2022 performance year. Applications can be submitted until 8 p.m. ET December 31, 2022.

New Resources Available: Electronic Clinical Quality Measure Fast Healthcare Interoperability Resources® Sparks Video Series
As part of continued education and outreach for emerging standards, CMS has developed a new video series entitled Electronic Clinical Quality Measure Fast Healthcare Interoperability Resources® Sparks. The intent of the eCQM FHIR Sparks series is to support health care quality leaders, health information technology vendors, and measure developers begin to explore the use of FHIR for quality measurement.

CMS Releases Informational Benchmarks to Help MIPS Eligible Clinicians Prepare for the 2023 Performance Period
As finalized in the Calendar Year 2022 Physician Fee Schedule Final Rule, CMS is removing the 3-point scoring floor in the Merit-based Incentive Payment System (MIPS) for quality measures that can be reliably scored against a benchmark. This policy will take effect beginning with the 2023 performance period.

CMS Reweighting 2021 MIPS Cost Performance Category
CMS recognizes the impact that the COVID-19 pandemic public health emergency (PHE) continued to have on clinicians and the services they provided in the 2021 performance period. Due to COVID-19’s impact on cost measures, they are reweighting the cost performance category from 20% to 0% for the 2021 performance period. The 20% cost performance category weight will be redistributed to other performance categories in accordance with § 414.1380(c)(2)(ii)(E).

Quality Payment Program

Promoting Interoperability

The Medicare Promoting Interoperability Program Hardship Exception Application for Eligible Hospitals and Critical Access Hospitals is Now Available
On May 1, CMS opened the Hardship Exception Application period for eligible hospitals and critical access hospitals that participated in the Medicare Promoting Interoperability Program in Calendar Year 2021. For the CY 2021 reporting period, CMS required that all eligible hospitals and CAHs use (1) existing 2015 Edition certification criteria, (2) the 2015 Edition Cures Update criteria, or (3) a combination of the two in order to successfully meet the program requirements, as finalized in the CY 2021 Physician Fee Schedule final rule (85 FR 84818 through 84828). CMS mandates that downward payment adjustments be applied to eligible hospitals and CAHs that were not meaningful users of CEHRT and score below the 50-point minimum requirement and failed to report two self-selected calendar quarters of eCQMs data on four self-selected eCQMs.

Now Available: Updated eCQM Specifications and Implementation Resources for 2023 Reporting/Performance Period
CMS has posted the eCQM specifications for the 2023 reporting/performance period for the Eligible Hospitals and Critical Access Hospitals, Hospital Hybrid, Outpatient Quality Reporting, and Eligible Clinician programs. CMS updates the specifications annually to align with current clinical guidelines and code systems so they remain relevant and actionable within the clinical care setting. Measures will not be eligible for 2023 reporting unless and until they are proposed and finalized through notice-and-comment rulemaking for each applicable program.

Medicare Promoting Interoperability Program 2022 Specification Sheets are now Available
CMS has released the specification sheets for the 2022 Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals (CAHs). The specification sheets provide a guide to the program’s measures. scoring details, and additional resources for participating eligible hospitals and CAHs.

“Medicare and Medicaid Promoting Interoperability Programs” becomes “Medicare Promoting Interoperability Program for eligible hospitals and CAHs” after ending of Medicaid Promoting Interoperability Program
With the Medicaid Promoting Interoperability Program ending in program year 2021, CMS has changed the Medicare and Medicaid Promoting Interoperability Programs name to the Medicare Promoting Interoperability Program for eligible hospitals and CAHs.” Previously, information distributed under the Promoting Interoperability Programs listserv was for participants of either program. Moving forward, information distributed through this listserv will be only relevant for eligible hospitals and critical access hospitals participating in the Medicare Promoting Interoperability Program.

Administrative Simplification

Administrative Simplification Enforcement and Testing Tool
The Administrative Simplification Enforcement and Testing Tool (ASETT) is now available for use through the CMS ID Management (IDM) system.

You can use ASETT to file a complaint with the CMS National Standards Group (NSG) about alleged violations of the HIPAA Administrative Simplification requirements.

Compliance Review Program Findings
The CMS National Standards Group, on behalf of HHS, administers the Compliance Review Program. The program aims to promote compliance with HIPAA Administrative Simplification rules for electronic health care transactions. Since the program launched in April 2019, NSG has conducted 20 compliance reviews with a mix of clearinghouses and health plans.

To help covered entities prepare for compliance reviews, CMS has created a report with the most common violations of standards and operating rules from the reviews.

Find out more about the Compliance Review Program on the Administrative Simplification website.

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