Mar 15, 2018 - Are Pediatrics required to report to the Quality Payment Program (QPP)? ... participants have suggested t
Quality Payment Program Office Hours March 15, 2018 Questions & Answers: Are Pediatrics required to report to the Quality Payment Program (QPP)? Pediatricians usually do not exceed the low-volume threshold of $30,000 in Medicare Part B paid claims and 100 Medicare Part B patients and therefore, are not individually eligible clinicians for the QPP. However, many clinicians are part of larger groups that do exceed the low volume threshold. If a group that exceeds the low volume threshold chooses to report as a group, the pediatricians, as well as all associated eligible clinician’s data would be included in the group report. Does the QPP attestation portal have an output report once attestation data is entered indicating where clinicians may still need to enter information? The current Centers for Medicare & Medicaid Services (CMS) reporting portal does not have a comprehensive output or submission report. Individuals and groups may submit data up until the reporting deadline of March 31, 2018. In the event a clinician has multiple data sets in the portal, the clinician will receive the score associated with the data set with the highest score. Lake Superior Quality Innovation Network (Lake Superior QIN) has received a lot of feedback from clinicians expressing concern regarding the lack of confirmation after submitting data. Lake Superior QIN will share this feedback with CMS to improve reporting functionality in future reporting years. How does a clinician know when Quality and Improvement Activities have been submitted for evaluation under the QPP program, especially when submitting claims for Quality or when using the Medicare Shared Savings Program (MSSP) Track 1 Accountable Care Organization (ACO) to earn credit for Quality and Improvement Activities? The QPP attestation portal does not house updated information on claims reporting for Quality measures or data relating to Merit-based Incentive Payment System (MIPS)-Alternative Payment Model (APM) or Advanced APM participation. CMS is currently developing a real-time dashboard for claims data submitted for evaluation for the quality category of QPP. For ACO participation, CMS will utilize data submitted through the ACO along with the data submitted via the QPP attestation portal and provide results to the clinician or group after the MIPS attestation deadline has closed. Expect the feedback to be available by July 31, 2018.
Lake Superior Quality Innovation Network serves Michigan, Minnesota, and Wisconsin, under the Centers for Medicare & Medicaid Services Quality Improvement Organization Program. www.lsqin.org | Follow us on social media @LakeSuperiorQIN
What happens after your QPP data is submitted to the portal? How long will a clinician have to wait to get their final score? Similar to the Physician Quality Reporting System (PQRS) program, CMS is planning to use the same methodology for review of the QPP data submitted for evaluation. Currently the deadline to enter data into the QPP attestation portal is March 31, 2018. CMS will review the QPP data for each of the categories by July 31, 2018 and provide feedback to individuals and groups on their scores using the Quality and Resource Use Reports (QRUR). Individuals and groups will have an opportunity to review their scores and accept or dispute any findings shortly after. Any payment adjustments, whether they are upward or downward, would begin on January 1, 2019. Currently, under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) final rule, clinicians will know their final payment adjustment no later than 30 days prior to the start of the adjustment year When will clinicians be notified of their 2018 Merit-based incentive payment system (MIPS) eligibility status? The MIPS eligibility requirements changed from $30,000 Medicare Part B paid claims and 100 Medicare Part B patients in performance year 2017 to $90,000 Medicare Part B paid claims and 200 Medicare Part B patients in performance year 2018. The MIPS eligibility look-up tool found at https://qpp.cms.gov/ reflects performance year 2017. CMS will be updating this look-up tool sometime after April, 2018. Lake Superior QIN and CMS will sent out notifications when the update occurs. What is the MIPS reporting Process? Enterprise Identity Data Management (EIDM) service account is required for submitting data to the CMS Web Portal. Lake Superior QIN has developed a “Quick Start Guide” for obtaining an account. The guide can be found at https://www.lsqin.org/wp-content/uploads/2018/03/EIDM_setup_guide.pdf. Don’t wait to set up your EIDM account up. Currently, the lead time to create and receive approval for a new EIDM account can be up to five business days. If you experience issues with the EIDM portal or even the QPP attestation portal, some of the participants have suggested trying a different web browser prior to submitting a ticket to the helpdesk. Disclaimer: Information provided in this presentation is based on the latest information made available by the Centers for Medicare & Medicaid Services (CMS) and is subject to change. CMS policies change, so we encourage you to review specific statutes and regulations that may apply to you for interpretation and updates.
Lake Superior Quality Innovation Network serves Michigan, Minnesota, and Wisconsin, under the Centers for Medicare & Medicaid Services Quality Improvement Organization Program. www.lsqin.org | Follow us on social media @LakeSuperiorQIN This material was prepared by Lake Superior Quality Innovation Network, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The materials do not necessarily reflect CMS policy. 11SOW-MI/MN/WI-D1-18-27 032218
