MACRA Minute – July 2019

New: MIPS Final Feedback Reports Are Here

Last week, CMS released the MIPS final feedback reports for the 2018 performance year. Feedback includes your MIPS final score and detailed information on each category for which you submitted data.

We encourage you log in to the QPP Portal and view your performance feedback as soon as possible to ensure it is accurate. Answers to frequently asked questions about final feedback can be found in the 2018 Performance Feedback FAQs document. For help setting up a HARP account to access the QPP Portal, please refer to the QPP Access User Guide.

If you have any questions about your MIPS performance feedback report please contact us at 1-844-358-4021 or qpp-surs@telligen.com.


Now Open: Targeted Review Period

If, after reviewing your MIPS final feedback reports, you believe an error was made in your 2020 MIPS payment adjustment factor(s) calculation, you may request a Targeted Review. The following are circumstances in which you may wish to request a targeted review:

  • Errors or data quality issues for the measures and activities you submitted
  • Eligibility and special status issues (e.g., you fall below the low volume threshold and should not have received a payment adjustment)
  • Being erroneously excluded from the APM participation list and not being scored under the APM scoring standard
  • Performance categories were not automatically re-weighted even though you qualify for automatic re-weighting due to extreme and uncontrollable circumstances

Targeted Reviews MUST be submitted by September 30, 2019

The Targeted Review request form can be found on your performance feedback page in the QPP Portal.

Fill out the sections as they apply to you. After completing the Targeted Review request form, you will receive a confirmation email that the review has been submitted. You may also receive an email requesting documentation to support your request.

Once your review has been thoroughly researched and evaluated, you will receive an email stating your request was either approved or denied. Targeted Review decisions are final. There will be no further review after a decision has been made.

If you need assistance requesting a Targeted Review, please reach out to your Telligen SURS team at 1-844-358-4021 or the QPP Help Desk at 1-866-288-8292. For more information, please review the fact sheet and FAQ document linked below.

Register Now: CMS Webinars

Save the Dates: August LAN Webinar

Maximizing your Quality Score: Beyond the Basics for Solo and Small Group Practices This upcoming event will focus on techniques and advice for maximizing your quality score, including using claims, EHRs and registries to submit your quality data.


Register Now: Telligen QPP Webinars

2018 MIPS Performance Feedback Reports Are Available…What Should I Do Now?

The final 2018 MIPS performance feedback reports have been released. Reports include each category score, final score and 2020 payment adjustment. 

Please join our Telligen QPP SURS team, Michelle Brunsen and Kelly Smith, on Thursday, July 25, 2019, as they host a webinar. They will show you how to navigate the report, answer FAQs and guide you on how to submit a targeted review if there are discrepancies.

Register: Thursday, July 25, 2019 11:00 a.m. – 12:00 p.m. CDT


Coming Soon: MIPS Data Validation Audits

CMS has contracted with Guidehouse to conduct data validation and audits for a select number of MIPS eligible clinicians. Data validation and audits are processes that will help ensure MIPS is operating with accurate and useful data. 

MIPS eligible clinicians, groups and virtual groups are required by regulation to comply with data sharing requests, providing all data as requested by CMS. 

Audits will occur from July-September 2019, and will cover data submissions from both the 2017 and 2018 performance periods.

If you are selected for data validation and/or audit, you will receive a request for information from Guidehouse. It will be sent via email or by certified mail. Please be on the lookout for this notification. You will have 45 calendar days from the date of the notice to provide the requested information. 

Telligen SURS is here to assist you in meeting the requirements if you are selected for audit. Please contact us at 1-844-358-4021 or qpp-surs@telligen.com if you have any questions about audits or need any assistance.


Coming Soon! e-Prescribing Requirement

In 2018, the Iowa Legislature and Governor Reynolds passed House File 2377 which included a mandate that beginning January 1, 2020, all prescriptions (controlled and non-controlled substances) must be transmitted electronically from prescriber to pharmacy. 

Certain situations may warrant an exemption including: economic hardship, technical limitations that the practitioner, medical group or pharmacy can’t control or other exceptional circumstances.

The Board may grant exception requests for up to one year, which may be renewable with Board approval. The Board is creating necessary forms and rules for the exception-petitionA prescriber who violates this mandate is subject to an administrative penalty of $250 per violation, up to a maximum of $5,000 per calendar year.

The administrative penalty assessed by the prescriber’s primary licensing board will not be considered a disciplinary action or reported as discipline.
More information can be found on the Iowa Board of Pharmacy website as well as on page 4 of their March newsletter.


Resources: New to the QPP Resource Library

The following resources were updated or added in June:

CMS Podcast: A Throwback to the 2019 HIMSS Conference

The fourth edition of the CMS podcast highlights some of the key perspectives from attendees at the 2019 Healthcare Information Management Systems Society Annual Conference.

Listen to the podcast here or find it on iTunes or Google Play.


July is National Immunization Month

If you administer immunizations and are in active engagement with your state immunization information system, you can report this as one of your Public Health and Clinical Data Registries for the Promoting Interoperability category. 

All four states in our region have qualifying immunization registries; click on the links below for more information.


This material was prepared by Telligen QPP-SURS Resource Center, the Quality Payment Program for Iowa, Nebraska, North Dakota and South Dakota, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. HHSM-500-2017-00012C.

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