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January 12, 2017
Submission of 2016 Reporting Data Updates and Deadlines
This material was prepared by Telligen, the Medicare Quality Innovation Network Quality Improvement Organization, 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 policy11SOW-QIN-D1-12/15/16-11918
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• Telligen: Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Colorado, Illinois and Iowa
• Subject Matter Experts for CMS Quality Performance Initiatives
Telligen QIN QIO
Sandy Swallow, CMA Program Specialist Iowa
Linda Brewer Sr. QI Facilitator Illinois
Temaka Williams HIT Advisor Illinois
Courtnay Ryan QI Facilitator Colorado
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Physician Quality Reporting System
PQRS Updates
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Date Milestones
January 1, 2017 • First day to submit 2016 PQRS data using registry, EHR, or QCDR. • Payment adjustments begin for both group practices and individuals who did
not satisfactorily report quality data to CMS in 2015 • 2016 GPRO Web Interface submission will be in the first quarter, stay tuned for
exact dates. • First transitional performance year begins for the QPP program for both group
practices and individuals. (Note: 2017 program year data will determine the 2019 payment adjustment)
February 24, 2017 • Last day that 2016 claims will be processed to be counted for PQRS reporting to determine the 2018 payment adjustment
February 28, 2017 • Last day to submit 2016 CQMs for dual participation in PQRS and the Medicare EHR Incentive Program
• Last day for QCDRs (QRDA) and EHRs to submit 2016 data
March 31, 2017 • Last day for 2016 QCDRs (XML only) and registries to submit 2016 data
December 31, 2017 • Reporting for the 2017 QPP program year ends for both group practices and individuals. (Note: 2017 program year data will determine the 2019 payment adjustment)
Important PQRS Dates in 2017
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Medicare & Medicaid EHR Incentive
Programs
MU Updates
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Date Milestones
January 1, 2017 • Payment adjustments begin for providers who did not satisfactorily report data to CMS in 2015
• First transitional performance year begins for the QPP program for both group practices and individuals. (Note: 2017 program year data will determine the 2019 payment adjustment)
January 3, 2017 • Medicare returning providers can attest to meaningful use for the EHR reporting period in 2016 (Note: 2016 program year data will determine the 2018 payment adjustment)
• Illinois, Iowa Medicaid returning providers can attest to meaningful use for the EHR reporting period in 2016; refer to your state Medicaid agency in other states
February 28, 2017 • Medicare EHR reporting period ends
March 31, 2017 • Illinois, Iowa Medicaid EHR reporting period ends; refer to your state Medicaid agency in other states
January 1, 2018 • Payment adjustments begin for providers who did not satisfactorily report to CMS in 2016
Important MU Dates in 2017
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Reporting Period MU Changes for 2016 and 2017
Reporting period any continuous 90-day for all returning and new participants
From Jan. 1 to Dec. 31 in CY 2016 and 2017
Applicable to EP, eligible hospitals and CAHs
Report CQMs by attestation for any continuous 90-day period during calendar year 2016
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New MU Participant Changes for 2016, 2017 & 2018
New Medicare participants in 2017 who are transitioning to MIPS can apply for a significant hardship exemption for 2018 payment adjustment
New Medicare participants in 2018 will be allowed to attest to Modified Stage 2 Objectives
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EPs – 2016 MU Reporting Requirement Changes and Alternate Exclusions
• Secure Electronic Messaging (EPs Only) – Phased approach
– For 2016 at least one patient (or authorized representative) seen by the EP during the reporting period sends or receives a secure message
– Secure Electronic Messaging Specification Sheet
• Public Health Reporting – EPs must meet 2 measures
– Option to Claim Alternate Exclusion for Syndromic Surveillance and Specialized Registry Reporting
– Public Health Reporting Tip Sheet for EPs in 2016
• CPOE – EPs scheduled to be in Stage 1 in 2016 may claim an alternate exclusion for Laboratory and
Radiology orders
– Alternate Exclusion Fact Sheet
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EHs and CAHs – 2016 MU Alternate Exclusions
• Public Health Reporting – Must meet 3 measures
– Option to Claim Alternate Exclusion for Specialized Registry Reporting
– Public Health Reporting Tip Sheet for EHs and CAHs
• CPOE – Scheduled to be in Stage 1 in 2016 may claim an alternate exclusion for Laboratory and
Radiology orders
• eRX – Scheduled to be in Stage 1 in 2016 or if in Stage 2 but did not intend to select the Stage 2 eRx
objective may claim an alternate exclusion
• Alternate Exclusion Fact Sheet
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EPs - Key Takeaways for MU 2016
• Non-participation in 2016 will receive a payment adjustment in 2018 (up to -4%).
• Medicare providers are not affected by MACRA or Quality Payment Program in 2016.
• Payment adjustment for EPs under the Medicare EHR Incentive Program will end after CY 2018.
• Medicaid EHR Incentive Program will continue until year 2021. Contact your Medicaid state agency for more information.
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Preparing for MU Attestation
• Log into the CMS EHR Registration and Attestation System to verify information and password are correct
• Obtain correct CMS EHR certification number – https://chpl.healthit.gov
• Identify a 90-day or greater reporting period for attestation including for the CQMs
• Complete EP or EH Attestation Worksheet for 2016 – Use it as a reference when attesting
• Be prepared for an audit – Supporting Documentation for Audits Tip Sheet
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EHs and CAHs - MU Measure and Objective Changes in 2017
Eliminates the Clinical Decision Support (CDS) objective and measure
Eliminates the Computerized Provider Entry (CPOE) objectives and measures
Reduces the View, Download and Transmit requirement to at least one patient for Modified Stage 2 and Stage 3
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Stages of Meaningful Use
Medicaid EPs, Medicare EH and CAH, Dual-eligible EH and CAH
2018 Stage 3 for ALL
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Quality Payment Program
QPP Updates
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Date Milestones
January 1, 2017 • First transitional performance period begins
October 1, 2017 • Last chance to start 90-day reporting period
November 1, 2017 • 2018 performance thresholds announced
December, 2017 • Notification of low volume threshold announced
January 1, 2018 • Second transitional performance period begins
Jan. 2 – Feb. 28, 2018 • Submission period for 2017 performance data
November 1, 2018 • 2019 performance threshold announced
December, 2018 • Notification of low volume threshold exception (9/1/2017 - 8/31/2018)
December 31, 2018 • QPP transitional reporting period completed
Important QPP Dates in 2017 and 2018
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• QPP Website Update 12/29
– ACI Fact Sheet
– ACI Specification Sheets
– Learn More About Improvement Activities and APMs
– 2017 Quality Benchmarks
– Comprehensive List of Advanced APMs
– APMS: Medicaid Models and All-Payer Models
– Technical QRDA-III Instructions for CY2017 reporting
QPP Updates
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• Sign-up for 2017 Study to Receive Full Clinical Practice Improvement Activities Credit
– Participate in focus groups
– Complete survey questionnaires
– Submit at least 3 CQMs to CMS
– Submit application to [email protected] by Jan. 31
QPP Updates
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• Upcoming Coffee Talks with subject matter experts: – Open discuss with Q & A – dedicated to your questions
– 2nd Thursday every month
– 11:00 a.m. CST for 1 hour
Feb. 9th: Demonstration on using the quality measures data selection tool
March 9th: TBD
April 13th: TBD
• Coming Soon - Educational Learning Modules for eligible clinicians with “free” CME/CEUs
We Are Here to Help!
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Resources
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Q & A Session!
Contacts: • Iowa – Sandy Swallow
– 515-223-2105
• Illinois – Linda Brewer
– 630-928-5819
• Illinois -Temaka Williams
– 630-928-5825
• Colorado – Courtnay Ryan
– 720-554-1711
www.TelligenQINQIO.com
