Recently, we informed you that the Centers for Medicare and Medicaid Services (CMS) released a status tool on the Quality Payment Program (QPP) website for performance feedback for clinicians included in the Merit-based Incentive Payment System (MIPS) during the 2017 performance year. This status tool allows clinicians to check to see if their payment adjustment for 2019 (based on the 2017 data) will be positive, neutral, or negative. In conjunction with the status tool, there was an open period to request a targeted review of your data until October 1, 2018.
Status Tool for 2017 Qualifying APM Participant and MIPS APMs DataNow Available
If you participate in the Merit-based Incentive Payment System (MIPS), you should have reviewed your 2017 performance feedback by now. The 2017 MIPS performance feedback, reflecting activities in performance year one of the QPP (2017), indicates if you will receive a negative, neutral, or positive payment adjustment in 2019. If you believe an error has been made in your 2019 MIPS payment adjustment calculation, you can request a targeted review until October 1, 2018. The following are examples of circumstances in which you may request a targeted review:
Ongoing efforts at the American Society of Nephrology (ASN) to develop a Comprehensive Kidney Care (CKC) Model received a boost last week after Senator Bill Cassidy, MD (R-LA), met with Crystal A. Gadegbeku[i], MD, FASN, and Daniel E. Weiner[ii], MD, FASN, co-chairs of a joint working group leading development of the model.
Medicare has proposed changes to the payment rules for dialysis care and physician reimbursement for calendar year 2019. While several proposed changes are positive, one proposed adjustment to the Evaluation and Management (E&M) coding reimbursement structure has created serious concern and will be a priority in the American Society of Nephrology’s (ASN) comments to Medicare.
Last week, ASN joined other kidney community stakeholders to meet with leadership at the Centers for Medicare and Medicaid Services (CMS) in Baltimore, MD, to discuss the future of the ESRD Prospective Payment System—more commonly known as “the bundle”—that provides reimbursement for dialysis care. Together with representatives from kidney patient organizations, dialysis organizations, and device manufacturers, ASN discussed with CMS the need for a mechanism to add new products to the bundle.
The Trump Administration on Tuesday, June 19, unveiled the final rule allowing potentially millions of small businesses and self-employed workers to buy health-insurance plans exempt from many Affordable Care Act (ACA) consumer protections. However, plans will still be barred from discriminating against or charging more for individuals with pre-existing conditions. The American Society of Nephrology (ASN) is reviewing the details of the rule now.
The Centers for Medicare & Medicaid Services (CMS) updated its Quality Payment Program Look-Up Tool, yesterday on June 14th, to allow clinicians to view 2018 Merit-based Incentive Payment System (MIPS) eligibility and Alternative Payment Model (APM) Qualifying APM Participant (QP) data—in one place. Additionally, the look-up tool name was changed from the MIPS Participation Status Tool to the Quality Payment Program Participation Status Tool to reflect the changes CMS made.
The American Society of Nephrology (ASN) member, Jonathan Jaffery, MD, MS, MMM, is one of the five newest members who will serve on the Medicare Payment Advisory Commission (MedPAC). Dr. Jaffrey was appointed to serve on MedPAC by Gene L. Dodaro, Comptroller General of the United States and head of the U.S. Government Accountability Office (GAO), on May 30. At the same time, ASN announced that it has joined the Physicians’ Electronic Health Record Coalition (PEHRC), which is comprised of ASN and 25 other medical societiesrepresenting more than 600,000 physicians, who share information to support the use of health information technology (IT). ASN’s lead nephrologist in the coalition is Daniel E. Weiner, MD, FASN, and chair of the ASN Quality Committee.