MIPS 2020 AUGUST 27, 2020 PRESENTER: MAGGIE DELCAMP, RN EHR - - PowerPoint PPT Presentation

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MIPS 2020 AUGUST 27, 2020 PRESENTER: MAGGIE DELCAMP, RN EHR - - PowerPoint PPT Presentation

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(877) 243-8881 MIPS 2020 AUGUST 27, 2020 PRESENTER: MAGGIE DELCAMP, RN EHR SPECIALIST & MIPS CONSULTANT 1 8/28/2020 AZCOMP.COM (877) 243-8881 MIPS 2 S 2020 : : I Inf nformation n & Planni nning ng What will this webinar

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MIPS 2020

AUGUST 27, 2020 PRESENTER: MAGGIE DELCAMP, RN

EHR SPECIALIST & MIPS CONSULTANT

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MIPS 2 S 2020 : : I Inf nformation n & Planni nning ng

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What will this webinar include?

  • MIPS in a Minute overview
  • Potential financial impact
  • 2019 finalized scores are in
  • Minimum requirements for 2020
  • Hardship Application
  • MIPS Training & Assistance Available
  • Q & A
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LET’S GET STARTED!

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Disclaimer

Please note that his information was current as of April 9, 2020 at 11am, however new guidance is being delivered daily, please check cited resources frequently for updates! Disclaimer: Although AZCOMP Technologies, Inc. makes every effort to ensure that information regarding MIPS

and other government programs are checked and accurate in both our documentation and training, the Medicare/Medicaid programs are constantly changing and individual providers may have unique circumstances that go beyond the typical guidelines laid out in the respective programs they are participating in. Therefore, it is the sole responsibility of each provider to study, interpret and remain abreast of the Medicare/Medicaid program requirements and deadlines, contacting program administrators directly as needed. Any documentation and training provided by AZCOMP Technologies, Inc. is based on our interpretation of the programs and certification rules published by the Department of Human Services and are subject to change. Information and training provided is “as is” and without any express or implied warranties. AZCOMP Technologies, Inc. assumes no responsibility for any inaccuracies, errors, or omissions, expressly disclaiming liability for damages of any kind arising out of the use of, reference to or reliance on any content provided. Using certified electronic health record (EHR) systems and other certified health IT to provide and attest to meaningful use is the sole responsibility of the eligible provider.

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The latest MIPS regulations can be found on the CMS web site at https://qpp.cms.gov/

EHR Incentive Program Information Center - Phone: 1-866-288-8292 Email: QPP@cms.hhs.gov

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MIPS REVIEW IN A MINUTE

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The Beginning: MIPS IS INTRODUCED

Medicare

Meaningful Use PQRS (Physician

Quality Reporting System)

Value Based Payment Modifier

MIPS

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SUMMARY OF PARTICIPATION

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Collect Data

  • Performance period during

calendar year

Report Data

  • Historically Q1 of the

following year

  • Jan 4 – Mar 31, 2021.

Feedback Available

  • Generally in the

Summertime

Payment Adjustment

  • Begins 2 years after

performance year

Jan – Dec 2020 Jan 4 - March 31, 2021 TBD Adjustment applies 2022

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CATEGORIES & WEIGHTS CHANGE

2017

Quality - 60% Advancing Care Information (ACI) - 25% Improvement Activities (IA) - 15%

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2018

Quality - 50% Promoting Interoperability (PI) - 25% Improvement Activities (IA) - 15% Cost - 10%

2019

Quality - 45% Promoting Interoperability (PI) - 25% Improvement Activities (IA) - 15% Cost - 15%

Cost 15% Quality 60% ACI 25% IA 15% Quality 50% Quality 45% IA 15% IA 15% PI 25% PI 25% Cost 10%  

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PRELIMINARY SCORE

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YEAR

FULL Negative Payment Adjustment PARTIAL Negative Payment Adjustment NEUTRAL Adjustment POSITIVE Adjustment POSITIVE Adjustment + Exceptional Performer Bonus

2019

[applies 2021]

0 Points (-7%) 1 – 29 points 30 points 30 – 75 points > 75+ points 2018

[applies 2020]

0 Points (-5%) 1 – 14 points 15 points 16 – 69 points > 70+ points 2017

[applies 2019]

0 Points (-4%) 1 – 3 points 3 points 4 – 69 points > 70+ points

  • %
  • %

+ % + %

Adjustment is based on MIPS Final Score

THRESHOLDS . INCREASE

|

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PAYMENT ADJUSTMENT TIMELINE

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Have you decided how you will participate in MIPS for 2020?

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NOW AVAILABLE: 2019 Feedback

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THE FINANCIAL IMPACT

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MIPS Payment Adjustment

Annual Medicare Part B Reimbursement 2017 (4%) 2018 (5%) 2019 (7%) 2020 (9%) $90k $3,600 $4,500 $6,300 $8,100 $120k $4,800 $6,000 $8,400 $10,800 $150k $6,000 $7,500 $10,500 $13,500 $200k $8,000 $10,000 $14,000 $18,000

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TOTAL

(if no MIPS data was reported 2017- 2020)

$22,500 $30,000 $37,500 $50,000

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COVID-19 Response: Additional Flexibilities

  • Expanded availability to apply for exception
  • Doubled Complex Patient Bonus for 2020
  • NEW Improvement Activity COVID-19

Clinical Trials

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CMS COVID-19 Response & added flexibilities : https://qpp.cms.gov/about/covid19

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2020 STRATEGY

Learn, Plan & Manage

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2020 MIPS Breakdown

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Measures & Activities

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IMPROVEMENT ACTIVITIES

  • Collect data on the 6

required measures AND submit “yes” to 3 attestation statements.

  • Collect and report for the

SAME continuous 90-day performance period in CY 2020

  • Will need to select 2 – 4

activities

  • Perform and report for the

SAME continuous 90-day period in CY 2020 (or as

indicated by the measure description)

  • Will need to select and

report at least 6 measures

  • Collect data for each

measure for the 12-month reporting period (Jan-Dec)

* Applies to MOST Clinicians. Clinicians do not need to collect or submit and data for cost measures. CMS collects and evaluates that data for you.

COST PROMOTING INTEROPERABILITY QUALITY

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Promoting Interoperability (PI)

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PI Requirements

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2020 Promoting Interoperability Quick Start Guide: https://qpp-cm-prod-content.s3.amazonaws.com/uploads/822/2020%20Promoting%20Interoperability%20Quick%20Start%20Guide.pdf

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2020 EXCEPTION OPTIONS

EXTREME AND UNCONTROLLABLE CIRCUMSTANCES EXCEPTION

  • Allows you to request one or more

performance categories be reweighted to 0%.

  • Eligible Clinicians – Individual Clinicians,

Groups & Virtual Groups

  • Circumstances to Apply –
  • If you believe you have been affected by an extreme and

uncontrollable circumstance (such as the public health emergency triggered by the COVID-19 pandemic), you can apply for this exception.

MIPS PROMOTING INTEROPERABILITY PERFORMANCE CATEGORY HARDSHIP EXCEPTION

  • Allows you to request reweighting—

specifically for the PI category (to 0%).

  • Eligible Clinicians – Individual Clinicians,

Groups & Virtual Groups

  • Circumstances to Apply –
  • You're a small practice
  • You have decertified EHR technology
  • You have insufficient Internet connectivity
  • You face extreme and uncontrollable circumstances such as

disaster, practice closure, severe financial distress or vendor issues

  • You lack control over the availability of CEHRT

* Lacking 2015 Edition CEHRT does not qualify as a reason to submit an application.

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Both applications are available through QPP website using HARP account. https://qpp.cms.gov/login December 31, 2020 at 8 pm (ET) is the Deadline to Apply

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Will CMS automatically apply any of the exceptions?

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MIPS Promoting Interoperability Performance Category Hardship Exception (qualifying clinician types) Extreme and Uncontrollable Circumstances Exception (Individual clinicians) Extreme and Uncontrollable Circumstances Exception (Groups/Virtual Groups)

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CMS Documentation Says…

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https://qpp.cms.gov/participation-lookup

Checking Provider Status & Eligibility

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Wash your hands of potential surprises later

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Reweighting

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Reweighting categories varies based on the categories for which the waiver is requested.

https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1054/2020%20MIPS%20Exception%20Applications%20Fact%20Sheet.pdf

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Example of PI Hardship Reweighting

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Options for MIPS 2020 Reporting

Which option is right for YOU?

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Report data for ALL Categories [Quality, Promoting Interoperability, Improvement Activities] Report Some Categories & Will NOT apply for hardship Apply for hardship AND report SOME categories Apply for hardship AND may not report ANY categories. Do Nothing (no hardship application/no reporting)

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Report Data for AL ALL Categories

[Quality, Promoting Interoperability, Improvement Activities]

WHO

Clinicians who have been recording and reporting data all or most of the year and meet all the requirements for PI. Especially good option for those with complex patients or special status bonuses.

WHY

  • Potentially higher incentives

available.

  • Staying on track for future years

Understanding the Proposed 2021 Quality Payment Rule BY: HITECHANSWERS.NET AND SPHANALYTICS.COM

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Report SOME ME Categories & Will NOT OT Apply for Hardship

WHO

Clinicians who have been recording and reporting high quality data, but don’t want to report all

  • categories. (COVID-19 impact, etc.)

WHY NOT

  • Meeting threshold to avoid penalty is more

challenging than previous years.

  • Leaving points “on the table” for categories not

reported.

  • No additional financial incentive compared to

applying for hardship and reporting.

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Apply for Hardship AND ND Report SOME Categories

POTENTIAL PROS

  • The hardship can prevent categories not reported

from lowering your score.

  • Categories reported might score high and combined

with bonus points might result in a positive payment adjustment.

POTENTIAL CONS

  • “All eggs in one basket”

CONSIDER

This choice is a CALCULATED RISK. Check preliminary score before committing to this plan.

WHO

Clinicians who have been recording and reporting high quality data and want to report some categories or may qualify for special status or complex patient bonuses.

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Apply for Hardship AND ND May Not Report ANY NY Categories.

WHO

Clinicians who have not started collecting data for MIPS or who have been significantly impacted by COVID (or other circumstances) in collecting data for 2020.

WHY

  • Avoid penalties for 2020.
  • Get on track for future years
  • You always have the option to report

categories if it benefits you. PRO TIP: This is the perfect time to start preparing for 2021 MIPS. Take some time to set your MIPS goals and begin preparations for 2021.

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Do Nothing (no hardship application/no reporting)

WHO

Clinicians who automatically quality for the hardship and do not (or cannot) report any information.

RECOMMENDATION

  • Be certain the hardship has been

applied.

  • Begin planning for 2021
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  • 1. Log in to QPP:

https://qpp.cms.gov/login

  • 2. Click Exceptions

Application

  • 3. Then Add New Exception

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How do I apply for a hardship exception?

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  • 4. Select the Exception Type
  • 5. Select the Application

Type and enter the appropriate NPI or TIN as indicated

  • 6. Complete the submitter

information fields.

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Complete the details for your request

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Verify your status by logging into QPP

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MIPS To Do List

 Review your 2019 Feedback  Check / Monitor the Provider’s Status

 Using QPP Provider Lookup: https://qpp.cms.gov/participation-lookup  Logging into QPP Account: https://qpp.cms.gov/login

 Weigh your options and decide the best plan for 2020  Apply for hardship (if appropriate for your plan)  Continue working on 2020 measures  Consider a MIPS Assessment  Plan for 2021 and begin collecting data where possible

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Looking Ahead: MIPS in 2021

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T2021 Proposed Rule Overview Fact Sheet: https://qpp-cm-prod- content.s3.amazonaws.com/uploads/1100/2021%20QPP%20Proposed%20Rule%20Fact%20Sheet.pdf 2021 Quality Payment Program Proposed Rule: https://www.federalregister.gov/documents/2020/08/17/2020-17127/medicare-program-cy-2021- revisions-to-payment-policies-under-the-physician-fee-schedule-and-other 2021 MIPS Payment Adjustment Fact Sheet: https://qpp-cm-prod- content.s3.amazonaws.com/uploads/1110/2021%20MIPS%20Payment%20Adjustment%20Fact%20Sheet.p df

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Industry News – EPCS MANDATES

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13 – States with mandates already in effect 13 – States with mandates beginning 1/1/2021 2 – States with mandates coming during 2021 *Kansas-7/1/2021 & *Michigan -10/1/2021 3 – States with mandates beginning 1/1/2022 (CA, UT & MD) 6 – States with proposed legislation for mandates (WV, NJ, NH, NE, MT, MS)

ALL states – including those without mandates proposed WILL be impacted by the FEDERAL MANDATE in effect JAN. 1, 2020

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FEDERAL MANDATE: Every Prescription Conveyed Securely Act

H.R. 3528 “… The Every Prescription Conveyed Securely Act would

require prescriptions for controlled substances covered under Medicare Part D to be transmitted electronically, starting on January 1, 2021.”

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https://www.cbo.gov/publication/53967#:~:text=piece%20of%20legislation.- ,H.R.,starting%20on%20January%201%2C%202021.

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Subscribe o

  • r Chec

eck t the e Blog O Often en f for the e Most U Up to Date I e Industr try N y News

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https://www.azcomp.com/blog/

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How can AZCOMP help you from here?

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MIPS TRAINING & CONSULTING AVAILABLE

MIPS Assessment

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FREE

Consulting Services

  • MIPS
  • EHR
  • EDI
  • IT Services

For our New and Existing EHR Customers

A $499 value

Email il info fo@azc zcomp.com to r

  • request y

your M MIPS a assessme ment a and f for

  • r m

mor

  • re i

infor

  • rma

mation

  • n
  • n
  • n ou
  • ur ot
  • ther s

services.

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RELIABLE RESOURCES

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The QPP website: https://qpp.cms.gov/ The QPP Resource Library: https://qpp.cms.gov/about/resource-library

Contacting CMS

By Phone: 1-866-288-8292 (TRS: 711) Monday - Friday 8 a.m - 8 p.m ET By Email: QPP@cms.hhs.gov

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HELPFUL LINKS

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  • Check Provider Eligibility for MIPS: https://qpp.cms.gov/participation-lookup
  • Individual vs Group Participation: https://qpp.cms.gov/mips/individual-or-group-participation
  • 2020 Improvement Activities Performance Category Quick Start Guide: https://qpp-cm-prod-

content.s3.amazonaws.com/uploads/818/2020%20Improvement%20Activities%20Quick%20Start%20Guide.pdf

  • 2020 Promoting Interoperability Performance Category Quick Start Guide: https://qpp-cm-prod-

content.s3.amazonaws.com/uploads/822/2020%20Promoting%20Interoperability%20Quick%20Start%20Guide.pdf

  • 2020 Quality Measures Requirements: https://qpp.cms.gov/mips/quality-measures
  • 2020 Quality Payment Program (QPP) Exception Applications Fact Sheet: https://qpp-cm-prod-

content.s3.amazonaws.com/uploads/1054/2020%20MIPS%20Exception%20Applications%20Fact%20Sheet.pdf

  • QPP Access User Guide – (includes instructions to register for QPP login, appoint staff as representatives):

https://qpp-cm-prod-content.s3.amazonaws.com/uploads/335/QPP%2BAccess%2BUser%2BGuide.zip

Highly Recommend MIPS 2020 Quick Start Guide: https://qpp-cm-prod- content.s3.amazonaws.com/uploads/819/2020%20MIPS%20Quick%20Start%20Guide.pdf

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That’s all, f folks!

Give us a call (877) 243-8881 Or visit us at: www.azcomp.com Or email us at: info@azcomp.com Interested in another webinar? Check out: www.azcomp.com/events

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