The Centers for Medicare & Medicaid Services (CMS) published the Calendar Year (CY) 2020 FINAL Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS dictates Medicare rates and policies under Part B, while the Quality Payment Program (QPP) implements two key value-based payment programs: the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). The proposal is very long at over 1700 pages!
Since the team at Chirpybird Health IT Consulting are the experts of the MIPS Quality Payment Program we are bringing you the MIPS highlights to you section-by-section segments and give you the most pertinent bullets!
Overview: The threshold to avoid a penalty is changing. The performance threshold is rising from 30 points to 45!
Promoting Interoperability (PI)
Requires 2015 CEHRT
90 Day Reporting Period continues
Qualifying exemptions in this category will still re-weight the 25 points to Quality
Still performance based scoring. (Not all-or-nothing.)
Security Risk Analysis still a scoreless pre-requisite
CMS finalized their proposal to remove the opioid treatment agreement measure.
CMS is keeping the Query of Prescription Drug Monitoring Program (PDMP) measure as optional. Reporting will be a “Yes” or “No” instead of a numerator and denominator.
Improvement Activities (IA)
Double-check the activities you plan to use!
Staying at 15%
Changes to two of the measure types the Medicare Spending Per Beneficiary Clinician measure and Total Per Capita Cost measure.
Assign responsibility for services to a larger number of clinicians
Improve risk adjustment timeline
Avoid assigning costs that are incurred before a clinician begins providing services to a patient
Additionally, CMS proposes increasing the number of episode-based measures from 8 to 18 by adding 10 new measures:
Acute Kidney Injury Requiring New Inpatient Dialysis
Elective Primary Hip Arthroplasty
Femoral or Inguinal Hernia Repair
Hemodialysis Access Creation
Inpatient Chronic Obstructive Pulmonary Disease (COPD) Exacerbation
Lower Gastrointestinal Hemorrhage
Lumbar Spine Fusion for Degenerative Disease, 1-3 Levels
Lumpectomy Partial Mastectomy, Simple Mastectomy
Non-Emergent Coronary Artery Bypass Graft (CABG)
Renal or Ureteral Stone Surgical Treatment
Elective Outpatient Percutaneous Coronary Intervention (PCI)
Revascularization for Lower Extremity Chronic Critical Limb Ischemia
Routine Cataract Removal with Intraocular Lens (IOL) Implantation
Intracranial Hemorrhage or Cerebral Infarction
Simple Pneumonia with Hospitalization
ST-Elevation Myocardial Infarction (STEMI) with Percutaneous Coronary Intervention (PCI)
MIPS eligible clinicians and groups should become familiar with the changes for the 2020 reporting year. The QPP Final Rule has established higher performance thresholds and payment adjustments, so more reporting and planning will be necessary to avoid any penalties.
UPCOMING MIPS CERTIFICATION ONLINE WEBINAR WORKSHOP
Become a 2020 Certified MACRA-MIPS Final Rule Specialist (CMMPS)
December 11, 12, 2019 Only 1 hour per day
IMPORTANT: Attendance in live sessions is NOT required. Each class is recorded daily and available in 24/7 dashboard.
WORKSHOP DESCRIPTION: MACRA-MIPS is changing for 2020! The FINAL RULE has been realeased by CMS. This 2 hour session where we will review regulatory changes specific to the 2020 performance year. This course is for individuals who are already familiar with the regulatory requirements for the 2018 performance year and just need the deep dive on what will change moving into 2020.”
SAVE 20% OFF WORKSHOP REGISTRATION WITH CODE: CHIRPYBIRD20 AT CHECKOUT!
Click this link to register: https://www.4medtrainingcatalog.com/online-store/DECEMBER-LIVE-WORKSHOP-Become-a-2020-Certified-MACRA-MIPS-Final-Rule-Specialist-CMMPS-in-2-Hours-December-11-12-2019-p157719349
BLOG ARTICLE AUTHOR INFO: Robin Roberts Health Informatics and Quality Payment Program Subject Matter Expert, Product Development,“HIT Like a Girl” Podcast Co-Host. Original Article: https://chirpybirdinc.com/mips-2020-final-rule-what-you-need-to-know-in-easy-to-read-bullets/
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