ICYMI, here is recent communication from CMS.
Deadlines
Approaching
Reminder: The 2023 Merit-based Incentive Payment System (MIPS) Self-Nomination Closes on September 1
CMS would like to remind you that the end of the 2023 MIPS Self-Nomination for Qualified Clinical Data Registries and Qualified Registries is September 1, 2022, at 8 p.m. ET. The Self-Nomination form on the Quality Payment Program website will lock at the deadline, and users won’t be able to make additional edits. Please ensure that your 2023 MIPS Self-Nomination form is complete and then click the Submit for Review button on the QPP website before the deadline.
Submit Comments on Policy Changes for Quality Payment Program in 2023 Physician Fee Schedule Proposed Rule
CMS recently issued its proposed policies for the 2023 performance year of the Quality Payment Program via the Medicare Physician Fee Schedule Notice of Proposed Rule Making. The deadline to submit formal comments on the proposed rule is September 6, 2022.
How To Submit Your Formal Comment(s)
You must officially submit your comments in one of the following ways:
- Electronically (due no later than 11:59 p.m. ET on September 6, 2022)
- Through regulations.gov
- Mailed (due no later than 5 p.m. ET on September 6, 2022)
- Regular mail
- Express or overnight mail
- Hand or courier
Nomination Period Open for Clinician Expert Workgroups for MACRA Cost Measure Comprehensive Reevaluation
CMS and its contractor, Acumen, LLC, are seeking nominations for the Clinician Expert Workgroups that will be reconvened to provide input on the comprehensive reevaluation of 3 episode-based cost measures (EBCMs) first used in the Quality Payment Program (QPP) in the 2019 performance year. Stakeholders are invited to submit nominations through September 9, 2022, at 11:59 p.m. ET.
News
CMS Releases Proposed Rule to Improve Medicaid & CHIP Quality Reporting Across States
CMS released a notice of proposed rulemaking to promote consistent use of nationally standardized quality measures in Medicaid and the Children’s Health Insurance Program (CHIP). This will help identify gaps and health disparities among the millions of people enrolled in these programs.
CMS Discontinuing the Use of Certificates of Medical Necessity and Durable Medical Equipment Information Forms
As part of its ongoing efforts to increase access to care and to reduce unnecessary administrative burden for stakeholders, CMS will be discontinuing the use of Certificates of Medical Necessity (CMNs) and Durable Medical Equipment (DME) Information Forms (DIFs) for claims with dates of service on or after January 1, 2023. CMS suppliers must continue to submit CMN and DIF information for claims with dates of service before January 1, 2023 if it is required.
Learn About Changes to the Medicare Promoting Interoperability Program for 2023
On August 1, 2022, CMS issued the Fiscal Year 2023 Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System (PPS) Final Rule. Final changes to the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals include the following…
Performance Period 2022 Eligible Clinician Electronic Clinical Quality Measure Education and Outreach Webinar Series
CMS developed and published webinar content from the Performance Period 2022 Eligible Clinician Electronic Clinical Quality Measure Education and Outreach Webinar Series. PDF slides and links to the webinar video recordings are available to review on the eCQI Resource Center (under “Get Started with eCQMs – Implementing eCQMs Eligible Clinicians”).
Quality Payment Program
MIPS Automatic Extreme and Uncontrollable Circumstances Policy Applied for Parts of Kentucky
In response to the Federal Emergency Management Agency designation of the recent Kentucky severe storms, flooding, landslides, and mudslides as a major disaster and the Secretary of Health and Human Services determination that a public health emergency exists for certain counties in Kentucky, the Centers for Medicare & Medicaid Services has determined that the Merit-based Incentive Payment System automatic extreme and uncontrollable circumstances policy will apply to MIPS eligible clinicians in designated areas of Kentucky.
Now Available: 2021 MIPS Performance Feedback, 2021 MIPS Final Score, and 2023 MIPS Payment Adjustment Information
CMS has released Merit-based Incentive Payment System (MIPS) performance feedback and final scores for the 2021 performance year and associated MIPS payment adjustment information for the 2023 payment year. You can view your 2021 MIPS performance feedback, including your final score and 2023 payment adjustment on the Quality Payment Program website.
Now Available: 2023 Eligible Clinicians and Eligible Hospitals/Critical Access Hospitals Electronic Clinical Quality Measure Flows
CMS developed and published the 2023 electronic clinical quality measure flows to the eCQI Resource Center. The eCQM flows supplement eCQM specifications for the 2023 reporting period for Eligible Hospitals/Critical Access Hospitals, and the 2023 performance period for Eligible Clinicians. The eCQM flows are designed to assist in interpretation of the eCQM logic and calculation methodology for performance rates. The eCQM flows provide an overview of each of the population criteria components and associated data elements that lead to the inclusion or exclusions into the eCQM’s quality action (numerator).
Have you reviewed the #QPP policy proposals included in the 2023 Medicare Physician Fee Schedule Proposed Rule? Electronic comments are due by September 6, 2022, at 11:59 p.m. ET. Submit them here: https://t.co/IdOzYgdMwC #MIPS #APMs pic.twitter.com/Z8WeXRn6fz
— CMSGov (@CMSGov) August 5, 2022
Did you participate in #MIPS during the 2021 performance year? If so, you can sign in to your #QPP account now to view your performance feedback, which includes your final score and 2023 payment adjustment: https://t.co/ssEofkCeps pic.twitter.com/5nmP8pz09c
— CMSGov (@CMSGov) August 25, 2022
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.
Administrative Simplification
Claim status transactions are used by providers and payers communicating about the status of a health care claim. Access our fact sheet to learn about the required standards and operating rules for these transactions: https://t.co/NN6EQMj5d5 #AdminSimp pic.twitter.com/deLcPbU8vA
— CMSGov (@CMSGov) August 25, 2022
Have questions about the #HIPAA Administrative Simplification requirements for electronic health care transactions? Our FAQs may be able to help. Find them here: https://t.co/y3FKAM5CqT #AdminSimp pic.twitter.com/l2YhSQOlak
— CMSGov (@CMSGov) August 23, 2022
MLN Matters Articles
- Significant Updates to Internet Only Manual (IOM) Publication (Pub.) 100-05 Medicare Secondary Payer (MSP) Manual, Chapter 5
- International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) — January 2023 Update
- International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) — January 2023 Update – 2 of 2
- Quarterly Update for Clinical Laboratory Fee Schedule (CLFS) and Laboratory Services Subject to Reasonable Charge Payment
- Update to Hospice Payment Rates, Hospice Cap, Hospice Wage Index, and Hospice Pricer for FY 2023
- Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update — Revised
- Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Updates for Fiscal Year (FY) 2023
- Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2023
- New Waived Tests
- Implementation of the Capital Related Assets (CRA) Adjustment for the Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies (TPNIES) Under the End-Stage Renal Disease Prospective Payment System (ESRD PPS) — Revised
- July 2022 Update of the Ambulatory Surgical Center (ASC) Payment System — Revised
Claims, Pricers, & Codes
- Integrated Outpatient Code Editor: Java Beta File Release
- Claim Status Category and Claim Status Codes Update
- Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – October 2022
- Integrated Outpatient Code Editor: Java Beta File Release
- ICD-10-CM Code Files: Fiscal Year 2023
- ICD-10 Medicare Severity Diagnosis-Related Group Version 40
- Integrated Outpatient Code Editor: Java Beta File Release
- Claims Processing Instructions for the New Hepatitis B Vaccine Code 90759
- HCPCS Application Summaries & Coding Decisions: Drugs & Biologicals
- New Edit for Prospective Payment System (PPS) Outpatient and Inpatient Bill Types Receiving an Outlier Payment When a Device Credit is Reported
- Long COVID: Use ICD-10 Code U09.9
CMS Innovation Center
CMMI Model Data Sharing (CMDS) Initiative Makes Model Participation Data Available to Researchers
CMS is pleased to announce the availability of new Research Identifiable Files (RIFs) for six CMS Innovation Center models.
CMS is releasing participation data for the following models:
Findings are in! The InCK Model pre-implementation period shows awardees were educating providers & communities, combining data, making navigating service delivery easier, + tailoring care coordination approaches to their community needs: https://t.co/ynPfMk153a pic.twitter.com/nOVLi47cHz
— CMS Innovation Ctr (@CMSinnovates) August 23, 2022
We are still accepting applicants through 9/27/22 for our CMS Innovation Center fellowship appointment. Apply here: https://t.co/9vCqO0L6R2 #CMMICareers pic.twitter.com/5OVLDxZqz9
— CMS Innovation Ctr (@CMSinnovates) August 22, 2022
Missed the Quality Payment Program Advanced Alternative Payment Model initiatives listening session on July 21? The transcript, recording, & slides from the event are now available, as well as materials from past listening sessions: https://t.co/NThQTesylb pic.twitter.com/cfi1vf5KLs
— CMS Innovation Ctr (@CMSinnovates) August 17, 2022