Quality-Reimbursement Announcements

Previous Announcements

11/12/2018 - CMS Updates 2018 QPP Participation Status for 2nd Snap Shot Date


CRNAs participating in Alternative Payment Models (APMs) can utilize CMS’ Quality Payment Program (QPP) Participation Status Tool to determine whether they are included in an Advanced APM as a Qualifying Participant (QP) and check their MIPS APM status. This update covers the QPP’s second snapshot period of January 1 to June 30, 2018 for the 2018 performance year.  CRNAs who are considered QPs are exempt from participating in the Merit-based Incentive Payment System (MIPS) program and are eligible to receive the 5 percent incentive bonus in the 2020 payment year.  Clinicians who are in MIPS APMs are eligible to be scored under the MIPS APM Scoring Standard.  Checking one’s QP status and MIPS APM status can be done in two ways: (1) as an individual using your National Provider Identifier (NPI) or (2) as a part of a group practice at the APM entity level using your group’s Enterprise Identity Management (EIDM) credentials. The updated Status Tool includes information on eleven Advanced APMs and MIPS APM in the QPP Program. 

10/11/2018 - MIPS Eligibility Status at TIN Level-QPP Participation Status Tool Available

Providers in group practices can now check MIPS eligibility for all the clinicians in their practices. The QPP website displays information on the eligibility status of every clinician associated with the Taxpayer Identification Number (TIN) by their National Provider Identifier (NPI).  To access the eligibility status of each clinician associated with the TIN, you will need to log into the CMS Quality Payment Program website with your EIDM credentials. See Participating in the Quality Payment Program – Year 2 for more information.  

10/11/18 - Submission schedule for CY2018 MIPS Performance Data

The MIPS data submission period for CY2018 data begins on January 2, 2019 and ends April 2, 2019. Providers who report via claims and the CMS Web Interface can submit data from January 22, 2019 until March 22. 2019. See the How to Submit 2018 Data guide for more details.

10/01/2018 - 2019 Virtual Group Election Period Begins October 1, 2018

CMS recently published a toolkit for individual providers and groups who elect to form a virtual group for the CY2019 MIPS Performance Year.  A virtual group is a combination of two or more tax identification numbers (TIN) assigned to one or more individual providers who are MIPS eligible, or one or more groups consisting of 10 or less providers (including at least one MIPS-eligible clinician) that elect to form a virtual group for a performance reporting year. The election period begins on October 1, 2018 and ends December 31, 2018.  The toolkit includes templates for virtual group agreement, election notification to CMS, and fact sheets about the election process and participation.

9/14/2018 - Targeted review request deadline extended

The deadline to submit targeted review requests was extended to October 15, 2018 at 8:00 pm (EDT) to allow additional time for anesthesia providers to access and review their performance feedback reports for CY2017. The 2019 MIPS Payment Adjustment Targeted Review Fact Sheet was updated to reflect the change.

CMS investigated some issues raised from targeted review requests for CY2017 MIPS Performance Feedback Reports. Several errors in scoring logic were found, related to the application of the 2017 Advancing Care Information; hardship exceptions under Extreme and Uncontrollable Circumstances; the awarding of Improvement Activity credit for successfully participating in the Improvement Activities Reduction Study, and adding the All-Cause Readmission measure to the MIPS final score.

As a result, the final scores for affected providers were corrected. This also resulted in slight changes in their payment adjustments. Anesthesia providers are encouraged to access and review their Performance Feedback Reports. A targeted review can be requested via the QPP Website.

8/24/2018 - Healthcare Provider Taxonomy Codes (HPTC) October 2018 Update

CRNAs should be aware that the updated HPTC code set scheduled for implementation on October 1, 2018 is now available. The list of codes can be viewed on the National Uniform Claim Committee website, or downloaded as a file from CMS using the keyword ‘taxonomy’. The current HPTC code for CRNAs, 367500000X has not changed or been updated for the October version. CRNAs should be aware that providers are directed to use only current HPTC codes to maintain claims data accuracy and achieve compliance with HIPAA electronic claims transmission standards. As a reminder, terminated codes are not approved for use after the date the new codes become effective, and specialty/provider codes issued from any organization other than the NUCC are invalid.

6/15/2018 - Enhanced Features to CMS Quality Payment Program MIPS and APM Look-Up Tools Now Available

Centers for Medicare & Medicaid Services (CMS) updated its Quality Payment Program Look-Up Tool 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.  With the enhanced tool, using your National Provider Identifier (NPI), clinicians can now review their MIPS participation status and/or their Predictive Qualifying APM Participant (QP) status based on calculations from 1/1/17 to 8/31/17.    CMS has also created the ability for group practices to download a list of all NPIs associated with the TIN to view eligibility status of every clinician in the group.   To obtain the detailed group list you must use your EIDM credentials and log into the CMS Quality Payment Program portal.  If you have questions about these tools and how to access them, please email QPP@cms.hhs.gov or call 1-866-288-8292 to speak with a QPP service representative.  

5/31/2018- MIPS Preliminary Performance Feedback Now Available

Clinicians who submitted 2017 Merit-Based Incentive Payment System (MIPS) data can review their Preliminary Performance Feedback data on the Quality Payment Program’s (QPP) website.  Clinicians must input their Enterprise Identity Management (EIDM) credentials into the website to access their information.  CMS notes that these scores are subject to change based on several factors that include but are not limited to:  special status scoring; calculations of the All-Cause Readmission measure; CAHPS survey results; and Improvement Activities participation and results. For those without EIDM credentials please see the EIDM User Guide for instructions on how to obtain them.  CMS anticipates that MIPS Final Scores will be published in July 2018.  

5/10/2018- New 2018 MIPS Eligibility Group Level Tool– Look up all NPIs Under a TIN

CMS now offers two ways to verify your MIPS participation status.  Individual clinicians can continue to go to the MIPS Participation Status Lookup website to verify whether they met the 2018 eligibility criteria using their individual National Provider Identifier (NPI).   For authorized uses that want to view group level data, you may now also choose to log in to the CMS Quality Payment Program website using your Enterprise Identity Management (EIDM) credentials to check your group’s 2018 eligibility for MIPS.   If you don’t have an EIDM account, start the process now by referring to the EIDM User Guide for instructions, noting that the portal still refers to the Physician Quality Reporting System (PQRS).  After logging into this new feature with your EIDM credentials, browse to the Taxpayer Identification Number (TIN) affiliated with your group, and you will be able to click into a details screen to see the eligibility status of every clinician based on their NPI within your group to verify whether you or your group members need to participate in the 2018 MIPS performance year.  The quality payment program helpdesk is prepared to answer questions about the look up tools and participation status by email (qpp@cms.hhs.gov) or phone (1-866-288-8292).

5/3/2018- MIPS Payment Adjustment Follows Individual Clinician NPI under new TIN

In recognizing that MACRA changed the way performance would be scored under the MIPS program, the Centers for Medicare & Medicaid Services (CMS) will continue to address the issues impacted by the MIPS payment adjustments in 2019 and beyond (see CMS slides 45-49 published 4/23/2018) .  In CY2017 Final Rule CMS-5517-FC (pages 77330 – 77332), CMS recognized the payment adjustment challenges faced by individual clinicians (ie, NPIs) associated with more than one group, clinicians using multiple submission mechanisms, and an NPI billing under a new TIN after the performance period.  In their final rule making, CMS determined that performance will follow the NPI even if they leave the group (ie, TIN) before the payment adjustment. CMS intends to “use the TIN/NPI's historical performance from the performance period associated with the MIPS payment adjustment, regardless of whether that NPI is billing under a new TIN after the performance period. In the event that an NPI bills under multiple TINs in the performance period and bills under a new TIN in the MIPS payment year, [CMS will take] the highest final score associated with that NPI in the performance period.”  Unlike PQRS, CRNAs should now be aware that their best MIPS score will follow them into a new TIN.  To learn more about how to participate in the MIPS program visit the AANA Quality Payment Program website. 

4/18/2018- Burdened by MIPS? Extended Deadline for CMS MIPS Reporting Burden Study

CMS is inviting eligible clinicians to participate in a study that will examine the burden clinicians’ face when reporting MIPS Quality measures.  CMS is specifically targeting the following areas: (1) clinical workflows and data collection methods using different submission systems; (2) challenges clinicians have when they collect and report quality data; and (3) changes to try to lower clinician burden, improve quality data collection and reporting, and enhance clinical care. Successful participation in this study will result in full credit for the 2018 MIPS Improvement Activities performance category. CMS anticipates that the study will run from April 2018 to March 2019.  With the extended deadline applications are due April 30, 2018.  For more information about the study, please email MIPS_Study@abtassoc.com.

4/6/2018- CMS Releases 2018 MIPS Eligibility Tool

You can now use the updated CMS MIPS Participation Lookup Tool to check on your 2018 eligibility for the Merit-based Incentive Payment System (MIPS).  Just enter your National Provider Identifier, or NPI, to find out whether you need to participate during the 2018 performance year.  The look up tool has been updated to address the changes to low-volume threshold for MIPS eligibility.   CRNAs in APMs should be aware that the CMS will update the Alternative Payment Model (APM) participants look up tool at a later time.  For more information about the visit the AANA Quality Reimbursement Website to learn about how CRNAs are impacted by the Quality Payment Program and MIPS today. 

4/6/2018 - MIPS APMs to Advanced APMs: How to Make the Valuable Transition

The Centers for Medicare and Medicaid Services (CMS) is hosting a webinar series with APG to assist clinician groups better understand alternative payment models under MACRA and provide some “how-to” insight into APM implementation.   Subject matter experts from CMS will review the MIPS APM model and requirements for qualifying to become an advanced APM, while APG will offer their strategies behind how they made the transition for their organization/group and share any challenges/pitfalls during implementation.  This webinar will be held on April 30, 2018 at 12:00 pm – 1:30pm ET.  Register for this CMS sponsored webinar.

4/6/2018- New AANA Member Advantage Program - SCG Health QCDR

SCG Health specializes in making MIPS regulatory burdens more approachable so that you can plan how to respond with limited resources and time. AANA Members that become SCG Customers will receive a 10% discount off the retail base subscription of 2018 reporting at $275 per clinician for reporting Quality and Improvement Activities, which must include three or more SCG Health QCDR measures.  The discounted base subscription include submission of quality data to SCG Health, live on-shored call center and online support, data submission, data verification and communication to CMS as required. Contact qpp@scghealth.net  for more information or visit SCGhealth.com/QPP.  Data entry support for calendar year 2018 Quality data is available for AANA members for an additional $500 per clinician (discount does not apply).

3/29/2018 - MIPS 2017 Deadline Extended to April 3rd

CMS Extends the MIPS 2017  Data Submission Deadline from March 31 to April 3 at 8 PM EDT

If you’re an eligible clinician participating in the Quality Payment Program and would like to attest to an improvement activity, you now have until Tuesday, April 3, 2018 at 8 PM EDT to submit your 2017 MIPS performance data. This extension applies to registries as well. You can submit your 2017 performance data using the new feature on the Quality Payment Program website.

Go to qpp.cms.gov and click on “sign in” on the top right side of the web page. 

  • You’ll be required to log into the Quality Payment Program data submission feature using your Enterprise Identity Management (EIDM) credentials user name and password. If you don’t have an EIDM account, you’ll need to obtain one. Review this EIDM user guide and get started with the process as soon as possible. Currently, you should allow at least 5 business days for EIDM requests to be processed.
  • After logging in, the feature will connect you to the Taxpayer Identification Number (TIN) associated with your National Provider Identifier (NPI).
  • You’ll be able to report data either as an individual or as a group. Be sure to login and get familiar with the feature before you submit your data.

Please contact the Quality Payment Program by email at qpp@cms.hhs.gov or toll free at 1-866-288-8292, if you need help or have questions about using the data submission feature.  

3/20/2018 - AANA QCDR and Registry Reporting FAQs Now Available

Though the AANA does not endorse any vendor or product through its Member Advantage Program,  the AANA does make a good faith effort to try to identify QCDR services that treat CRNAs with respect, value their business, and have developed a quality reporting business model that does not knowingly or purposefully make anesthesia provider distinctions. 

In an effort to assist CRNAs in better understanding the time and effort needed to participate in a QCDR or registry, the Research and Quality division has developed the QCDR and Registry Reporting FAQs. 

3/1/2018 - CMS MIPS Reporting Burden Study

Earn MIPS Points:  Participate in CMS MIPS Reporting Burden Study

CMS is inviting eligible clinicians to participate in a study that will examine the burden clinicians’ face when reporting MIPS Quality measures.  CMS is specifically targeting the following areas: (1) clinical workflows and data collection methods using different submission systems; (2) challenges clinicians have when they collect and report quality data; and (3) changes to try to lower clinician burden, improve quality data collection and reporting, and enhance clinical care. Successful participation in this study will result in full credit for the 2018 MIPS Improvement Activities performance category. CMS anticipates that the study will run from April 2018 to March 2019.  Applications are due March 23, 2018.

3/1/2018 - Brace for MIPS Program Changes in CY 2019

Some highly influential organizations are making proposals that could significantly alter the Merit-Based Incentive Payment Systems (MIPS) Program as it is currently defined.  Recently, the Medicare Payment Advisory Commission (MedPAC) recommended that the MIPS Program be repealed because its reporting requirements are too burdensome.  Similarly, the White House’s Proposed Budget for 2019 put forward that MIPS eliminate the Advancing Care Information and Improvement Activities performance categories, leaving only the Quality and Cost performance categories.  Adding more fuel to this fire to change MIPS, the Bipartisan Budget Act of 2018, Section 53106, recommends changing the Physician Fee Schedule update drop from 0.50 percent to 0.25 percent for CY 2019 only.  What will happen to MIPS in the future is up in the air, but the Research and Quality Division as well as Federal Government Affairs is actively monitoring all proposals that would affect the program.   As of now eligible MIPS CRNAs should stay the course and continue to participate according to the 2018 MIPS performance period requirements.  Please visit our Quality Reimursement for more information on MIPS and the Quality Payment Program.