12/18/2018

CMS-Medicare

Recent Oncology Related Articles

2019 Medicare Part D Opioid Policies: Training Materials

CMS will implement new opioid policies for Medicare drug plans on January 1. The new policies include:

• Improved safety alerts when patients fill opioid prescriptions at the pharmacy
• Drug management programs for patients at-risk for misuse or abuse of opioids or other drugs

CMS posted new training materials, including slide decks and tip sheets for:

• Prescribers
• Pharmacists
• Patients

CMS also recently released an MLN Matters® Article: A Prescriber’s Guide to the New Medicare Part D Opioid Overutilization Policies for 2019. Visit the Reducing Opioid Misuse webpage for more information on CMS’ overall strategy.

Quality Payment Program: Webinar Library

CMS moved Quality Payment Program (QPP) webinar resources to the newly redesigned QPP Webinar Library webpage. Search for the webinars and accompanying recordings, transcripts, and presentation slides by performance year, reporting track, performance category, and webinar type. For questions, contact QPP@cms.hhs.gov or 866-288-8292 (TTY: 877-715-6222). 

CY 2019 MPFS Final Rule: Summary of Policies MLN Matters Article — New

A new MLN Matters Article MM11063 on Summary of Policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List is available. Learn about policy changes.

MLN Catalog: December 2018 – Revised

A revised MLN Catalog – December 2018 is available. Learn about free:

• Products and services that can be downloaded
• Web-based training courses; some offer continuing education credits
• Helpful links, tools, and tips

Quarterly Provider Update

The Quarterly Provider Update is a comprehensive resource published by the Centers for Medicare & Medicaid Services (CMS) on the first business day of each quarter. It is intended to make it easier for providers, suppliers, and the general public to understand the changes CMS is proposing or making.
 
CMS publishes this update to inform the public about the following: 

• Regulations and major policies completed or cancelled.
• New/Revised manual instructions

The Quarterly Provider Update can be accessed on the CMS website.
 
We encourage you to bookmark this web page and visit it often for this valuable information. To receive notification when regulations and program instructions are added throughout the quarter, sign up for the Quarterly Provider Update Listserv.

Quality Payment Program: MIPS Resources

CMS posted new Merit-based Incentive Payment System (MIPS) resources:

• 2018 MIPS Cost User Guide: Overview of the MIPS Cost performance category, including measures, reporting requirements, and scoring
• 2018 MIPS Improvement Activities User Guide: Overview of the MIPS Improvement Activities
  performance category, including participation requirements, reporting methods, and scoring
• 2018 MIPS Specialty Measures Guides for Emergency Medicine, Ophthalmologists, Optometrists, Orthopedists, Pathologists, Podiatrists, and Primary Care: Overview of MIPS and provides a list of measures and activities that may apply to these specialty clinicians
• 2019 MIPS Quick Start Guide: High-level overview of who is eligible for MIPS in 2019 and how to
  participate
• 2018 CMS Web Interface Sampling Methodology: Outlines the sampling methodology for the 15 clinical quality measures and provides information on the number of beneficiaries each organization is expected to report on and how those beneficiaries are selected
• QP Methodology Fact Sheet: Overview of how CMS determines who is eligible to be a Qualifying
  Alternative Payment Model Participant (QP) and Partial QP

For More Information:

• Resource Library webpage
• Quality Payment Program website

Questions?

• Reach out to your local technical assistance organization
• Contact QPP@cms.hhs.gov or 866-288-8292 (TTY: 877-715-6222)

Physician Fee Schedule Call: Audio Recording and Transcript — New

An audio recording and transcript are available for the November 19 call on the Physician Fee Schedule Final Rule. During this call, CMS experts cover three provisions:

• Streamlining Evaluation and Management (E/M) payment and reducing clinician burden
• Advancing virtual care
• Continuing to improve the Quality Payment Program to reduce burden and offer flexibilities to help clinicians successfully participate

Physician Compare Preview Period Open through December 31

The Physician Compare preview period is open through December 31 at 8 pm ET. Preview your 2017 Quality Payment Program performance information before it will appear on Physician Compare profile pages and in the downloadable database. Access the secured preview through the Quality Payment Program website.

For More Information:

• Physician Compare Preview Period User Guide
• Medicare Learning Network Webcast
• Clinician Performance Information on Physician Compare: Performance Year 2017 Preview Period
• Group Performance Information on Physician Compare: Performance Year 2017 Preview Period
• For assistance accessing the Quality Payment Program website or obtaining your Enterprise Identity Management (EIDM) user role, contact QPP@cms.hhs.gov
• For questions about Physician Compare, public reporting, or the 30-day preview period, contact
  PhysicianCompare@Westat.com. 

QRURs and PQRS Feedback Reports: Access Ends December 31

The final performance period for the Value Modifier and Physician Quality Reporting System (PQRS) programs was 2016 and the final payment adjustment year is 2018. Quality and Resource Use Reports (QRURs) and PQRS Feedback Reports will no longer be available after the end of 2018. If you need these reports, download them through December 31, 2018, from the CMS Enterprise Portal using an Enterprise Identity Management (EIDM) system account with the correct role. Visit the How to Obtain a QRUR webpage for more information.

For access to PQRS Taxpayer Identification Number or National Provider Identifier reports from program year 2013 or earlier, contact the QualityNet Help Desk. They are no longer available from the QualityNet Secure Portal.

The Merit-based Incentive Payment System (MIPS) under the Quality Payment Program replaced the Value Modifier and PQRS programs. Visit the Quality Payment Program website to learn more. Note: QRURs and PQRS Feedback Reports are not same as the MIPS Performance Feedback.

For More Information:

• PQRS Analysis and Payment webpage: Information on PQRS Feedback Reports
• Value-Based Payment Modifier webpage: Information on QRURs
• For assistance with EIDM or PQRS Feedback Reports , contact the QualityNet Help Desk
• For assistance with the QRURs or Value Modifier, contact the Physician Value Help Desk at pvhelpdesk@cms.hhs.gov or 888-734-6433 (select option 4)

Recent LearnResource & MedLearn Matters Articles

• National Coverage Determination (NCD90.2): Next Generation Sequencing (NGS) (MM 10878)
• Next Generation Accountable Care Organization (ACO) Model 2019 Benefit Enhancement (Revised MM 10824)
• New Medicare Beneficiary Identifier (MBI) Get It, Use It (Revised SE 18006)
• Quarterly Influenza Virus Vaccine Code Update - January 2019 (Revised MM 10871)
• New Medicare Webpage on Patient Driven Payment Model (SE 18026)
• International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) (MM 11005)
• Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 25.0, Effective January 1, 2019 (MM 11044)