CMS has adjusted reporting requirements for the Quality Payment Program (QPP) in light of the COVID-19 situation. The 2019 Merit-based Incentive Payment System (MIPS) data submission has been extended from March 31 to April 30, 2020. Participating clinicians who do not submit data by April 30 will qualify for the “automatic extreme and uncontrollable circumstances policy” and receive a neutral payment adjustment for the 2021 payment year. CMS implemented the policy to provide relief to clinicians who are actively responding to COVID-19.
Congress has passed three stimulus packages to respond to the clinical and economic toll of the pandemic. The first package (“Phase 1”), passed March 4, provided billions of dollars to federal agencies to combat the virus’s spread and additional funds to ramp up testing. Phase 2 passed ten days later; it covered emergency provisions spanning food aid, paid sick leave, free COVID-19 testing for the uninsured, and unemployment insurance. Cost-sharing for visits relating to testing was waived for Medicare Part B, Medicare Advantage, Tricare, Medicaid/CHIP, Veterans, and Indian Health Service.
The president’s national emergency declaration on March 13 authorized states to apply for 1135 waivers granting time-limited flexibilities to respond to the crisis. As of Friday, 34 states had been granted Medicaid waivers that offer a range of flexibilities such as the abilities to enroll out-of-state or new providers more quickly and to temporarily suspend prior authorization requirements.
On March 17, CMS issued new guidance on telehealth services for Medicare beneficiaries to help providers more flexibly diagnose and manage patients during the novel coronavirus pandemic. Telehealth visits under Medicare are now reimbursed at the same rate as in-person visits, and practices have the flexibility to reduce or waive cost sharing for patients. This applies to physicians, nurse practitioners, clinical psychologists, and LCSWs.
On March 6, 2020, PCC submitted a letter to members of Congress to express opposition to HR 5741 "Strengthening Innovation in Medicare and Medicaid Act." This proposed legislation risks weakening CMMI's leadership role and autonomy.
On January 22, 2020, Governor Lamont of CT signed into law Executive Order No .5, which directs OHS to monitor healthcare spending across payers, set annual benchmarck for 2021 through 2025.
On Friday, September 27, 2019, PCPCC submitted formal comments regarding the physician fee schedule. Specifically, PCPCC commented on the evaluation and management (E/M) codes, Medicare coverage for opioid use disorder, physician supervision for physician assistants, care management services, payment bundles, and and updates to the Quality Payment Program.
On Thursday, September 5, the PCPCC submitted a letter of comments to CMS regarding support of some of the changes made in the proposed 2020 physician fee schedule such as the changes to E/M codes. More detailed, formal comments will be submitted to the Federal Register later in the month. Read the letter here.
On Friday, August 2, the PCPCC sumbitted a letter of comments and concerns to CMMI regarding some facets of the new Primary Care First Model. These included suggestions around the risk groups, performance incentives, and quality measures. Learn more and read the letter here.
The toolkit contains educational materials and training templates for effectively engaging patient advisors in research projects. Materials can be tailored for each research project.
