Quality Payment Program COVID-19 Response - Update April 6

The Centers for Medicare & Medicaid (CMS) is working rapidly to update policies and allow healthcare providers to flexibly apply best practices in response to the COVID-19 pandemic.  Programs such as Hospitals without Walls and the existing Patients over Paperwork have been deployed.  Removal of barriers have resulted in exponential growth of telehealth and remote patient monitoring.   Advanced payments to healthcare providers are being provided to counter the effects of changing patterns of healthcare use,  reduction in elective procedure, increase in ICU utilization and other ongoing unanticipated changes.

Specifically looking at Quality Payment Program COVID-19 response, CMS has provided the following guidance to date: 

• The 2019 MIPS data submission deadline has been extended to April 30.
• COVID-19 is identified as a triggering event for the MIPS Automatic Extreme and Uncontrollable Circumstances policy. This is only applicable to individual MIPS eligible clinicians.
• CMS re-opened the 2019 Extreme and Uncontrollable Circumstances application to individuals, groups and virtual groups, including those who have already submitted data.

Changes and clarifications from guidance provided two weeks ago include the following:

• Added information about extreme and uncontrollable circumstances application reopening as an option for 2019
• Added information about implications for facility-based clinicians
• Revised the question about Part B claims reporting to indicate that groups should submit an application
• Revised language to clarify that the automatic extreme and uncontrollable policy does not apply to group participation

Details are available on an updated Fact Sheet here.

In addition, looks at the 2020 QPP program,  there is a new Improvement Activity for the CY 2020 performance year that, if selected, will provide high-weighted credit for clinicians within the MIPS Improvement Activities performance category. Clinicians will receive credit for this Improvement Activity by participating in a clinical trial utilizing a drug or biological product to treat a patient with COVID-19 and then reporting their findings to a clinical data repository or clinical data registry. This will help contribute to a clinicians overall MIPS final score, while providing important data to help treat patients and address the current COVID-19 pandemic.

For additional information, contact Healthmonix.