Oct 12, 2017 - The link to the tool is https://data.cms.gov.qplookup. ... Merit-Based Incentive Payment System (MIPS) El
Quality Payment Program (QPP) Office Hours October 12, 2017
Reminders:
The Final 90-day reporting period for the transition year started October 24, 2017 Test Pace Clarification for Quality – A group or individual may submit one quality measure for one patient for one day to avoid a negative payment penalty. The Stratis Health MIPS Estimator Tool is now available as a Web-based tool. The Website is https://www.lsqin.org/initiatives/qpp/qpp-resources/. Centers for Medicare & Medicaid Services (CMS) released a new Alternative Payment Model (APM) Qualified Professional Look-up tool. The link to the tool is https://data.cms.gov.qplookup.
Summary of Discussion Items: Qualified Professional Determination At one point CMS said they expected most clinicians on an Advanced APM’s participation list to be Qualified Professionals (QPs). Given this statement, is it necessary to look up all clinicians to determine their QP Status? Yes. At this time, this is the best tool that is available to confirm status. Lake Superior Quality Innovation Network (QIN) realizes that this can represent a significant amount of work for large organizations but does not have any other solution to offer. Merit-Based Incentive Payment System (MIPS) Eligible Clinicians Changing Practices A caller asked about managing Eligible Clinicians that change practices. After the call, members for Lake Superior QIN did some research on this question and found clarifying information in the Federal Register. The Following is an excerpt from the Federal Registry page 3908. After consideration of these comments, we are finalizing our policy to use the Tax ID Number (TIN)/ National Provider Identifier 's (NPI) historical performance from the performance period associated with the MIPS payment adjustment, regardless of whether that NPI is billing under a new TIN after the performance period. In the event that an NPI bills under multiple TINs in the performance period and bills under a new TIN in the MIPS payment year, we are finalizing our alternative policy of taking the highest final score associated with that NPI in the performance period. During the next office hours, on Thursday, November 9, this will be discussed further. (Register here)
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
Group versus individual reporting Can an individual clinician that is part of group report also submit individually? Yes. When an organization with reporting under a TIN reports as a group all clinicians must be included in the group reporting however, an individual may also submit individual measures for scoring. CMS will take the higher of the two scores to determine the clinician’s payment adjustment. Improvement Activities Is there a place that one can find more information about the improvement activities? Specifically, where can I find information about the documentation needed? The best place to find this information is on the QPP website under the resource library. There is a ZIP file called MIPS Data Validation Criteria. Column G of the spreadsheet gives a brief description of the required documentation. Although not perfect, it is all that is available at this time. If you need any assistance finding the document, you can contact your State’s Lake Superior QIN representative.
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-D1-17-155 102517
