Jan 2021 MACRA Minute

2020 Data Submission

CMS has opened the data submission period for Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in the 2020 performance year of the QPP. Data can be submitted and updated until 7:00 p.m. CST on March 31, 2021.

How to Submit Your 2020 MIPS Data

Clinicians will follow the steps outlined below to submit their data:

  1. Go to the Quality Payment Program webpage.
  2. Sign in using your QPP access credentials (see below for directions).
  3. Submit your MIPS data for the 2020 performance year or review the data reported on your behalf by a third party.

Extreme and Uncontrollable Circumstances (EUC) Hardship Deadline Extension to February 1, 2021

To further support clinicians during the COVID-19 public health emergency, CMS is extending the 2020 MIPS Extreme and Uncontrollable Circumstances Exception application deadline to February 1, 2021.

For the 2020 performance year, CMS will be using the Extreme and Uncontrollable Circumstances policy to allow MIPS eligible clinicians, groups, and virtual groups to submit an application requesting reweighting of one or more MIPS performance categories to 0% due to the current COVID-19 public health emergency.

If you have any concerns about the effect of the COVID-19 public health emergency on your performance data, including cost measures, for the 2020 performance period, submit an application now and be sure to cite COVID-19 as the reason for your application.

If you have an approved application, you can still receive scores for the Quality, Improvement Activities and Promoting Interoperability performance categories if you submit data. If the Cost performance category is included in your approved application, you will not be scored on cost measures even if other data are submitted. Learn more in the 2020 Exceptions Applications Fact Sheet.

Final 2020 MIPS Eligibility Status

You can now visit the Quality Payment Program (QPP) Participation Status Tool and review your final 2020 eligibility status for the Merit-based Incentive MIPS. 

Review Your 2020 Eligibility

Your status may have changed, so we encourage you to use the QPP Participation Status Tool to confirm your final 2020 MIPS eligibility. 

If, after the first review earlier this year, you were determined to be:

  • Eligible for MIPS: Your eligibility status could have changed, and you may no longer be eligible. You should use the tool to make sure you’re still eligible.
  • Not eligible for MIPS at a particular practice: Your eligibility status, based on your association with that particular practice, didn’t change unless you were identified as a participant in a MIPS APM.

Please note, if you joined a new practice (meaning you billed under, or assigned your billing rights to, a new or different TIN) between October 1, 2019, and September 30, 2020, CMS evaluated your MIPS eligibility based on your association with that new practice (identified by TIN) during this second review.

Clinicians that joined a new practice after September 30, 2020 are not eligible for MIPS as an individual based on your association with that new practice (identified by TIN). However, you may be eligible to receive a MIPS payment adjustment based on your group’s participation, if the new practice you joined chooses to participate in MIPS as a group.

You can also view your initial 2021 MIPS Eligibility now using the QPP Participation Status Tool.

2021 MIPS Payment Adjustments

2021 MIPS payment adjustments, based on each MIPS eligible clinician’s 2019 MIPS Final Score, will now be applied to payments made for Part B covered professional services payable under the Physician Fee Schedule. Payment adjustments are determined by the final score associated with your Taxpayer Identification Number (TIN)/National Provider Identifier (NPI) combination.

MIPS eligible clinicians, identified by TIN/NPI combination for the 2019 performance period, will receive a positive, neutral, or negative MIPS payment adjustment in 2021 if they:

  • Were a clinician type that was included in MIPS;
  • Enrolled in Medicare prior to January 1, 2019;
  • Were not a Qualifying Alternative Payment Model (APM) Participant (QP);
  • Were a Partial Qualifying APM Participant (Partial QP) that elected to participate in MIPS as a MIPS eligible clinician; and
  • Met one of the following criteria:
    • Individually exceeded the low-volume threshold;
    • Were in a practice that exceeded the low-volume threshold at the group level and submitted group data or were part of an approved virtual group; or
    • Were in a MIPS APM and the APM Entity group exceeded the low volume threshold (This also includes Partial QPs who elected to participate in MIPS).

For More Information

Review the 2021 MIPS Payment Adjustment Fact Sheet for more details and answers to frequently asked questions.

Visit the Quality Payment Program Resource Library for more Quality Payment Program resources.

2021 QPP Final Rule Highlights

  • Beginning MIPS Value Pathways (MVPs) implementation in 2022 instead of 2021
  • Performance threshold of 60 points for 2021
  • Revising performance category weights for Quality (decreases from 45% to 40%) and Cost (increases from 15% to 20%)
  • Extending the use of the CMS Web Interface as a collection and submission type for reporting MIPS quality measures in 2021 and sunsetting the option beginning with 2022
  • Sunsetting the APM Scoring Standard and allowing MIPS eligible clinicians in APMs the option to participate in MIPS and submit data at the individual, group, virtual group or APM Entity level
  • Updating third party intermediary approval criteria as well as remedial action and termination criteria

Complex Patient Bonus COVID-19 Update in 2020

The final rule also increases the complex patient bonus from a 5- to 10-point maximum for clinicians, groups, virtual groups, and APM Entities for the 2020 performance year only to offset the additional complexity of their patient population due to COVID-19.

Performers of Excellence

The Telligen Quality Payment Program Support Center is pleased to sponsor the Telligen QPP SURS Performers of Excellence Award Program starting in 2021.

The Performers of Excellence Award Program will formally recognize physician practices that demonstrate excellence in quality improvement and are actively participating in the Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP) in 2021.

As part of the Performers of Excellence Award we will host a new call-in series called Telligen QPP Connect Live!  Each month we will highlight a topic with a few slides to kick off the call/start conversation and then you can ask questions (on the topic or anything else you would like).  These calls will happen the 3rd Wednesday of every month from 12:00 – 1:00 Central. The first call will be January 20th, highlighting the 2021 Final Rule. Please use the following information to join via computer or phone.

Join Zoom Meeting

Phone one-tap: US: +13462487799,,95908897340# or +16699006833,,95908897340#

Meeting URL: https://dsu.zoom.us/j/95908897340?pwd=dkVZSm5CM3EyQUpEQk1BZVFWdzh6UT09

Meeting ID: 959 0889 7340
Passcode: 761463

Join by Telephone
For higher quality, dial a number based on your current location.
Dial:
US: +1 346 248 7799 or +1 669 900 6833 or +1 253 215 8782 or +1 312 626 6799 or +1 929 205 6099 or +1 301 715 8592
Meeting ID: 959 0889 7340

CMS LAN Webinar

The next LAN Webinar, Implications of the Year 5 Final Rule for Solo and Small Group Practices, will now be held January 12th and 14th.  If you already registered for this event, you will be automatically registered for the corresponding January date and will receive an email notification from Adobe Connect (you can also register for the other date if needed). Please email qppsurs@impaqint.com if you do not receive this notification by 11/26/20.

              Tuesday January 12th 10-11am CT

              Thursday January 14th 2:30-3:30pm CT

Please save the date for the final LAN event, Key Insights for Success in MIPS and Lessons Learned. Registration is forthcoming

  • Tuesday February 9, 2020 – 11am-12pm EST
    • Thursday February 11, 2020 – 4pm-5pm EST
  • Telligen Webinars

Changes to the 2021 Quality Measures

This webinar provides detailed information on the general quality performance category updates, new and removed measures as well as those quality measures with substantive changes for the 2021 performance year.

New Resources in the QPP Resource Library

The following resources were updated or added in December

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