September 2018
New Medicare Card mailing update - Wave 6 (Colorado) begins

The Centers for Medicare and Medicaid Services continues to mail new Medicare cards to people with Medicare who live in Wave 5 states -- Alabama, Florida, Georgia, North Carolina, and South Carolina -- and last week began mailing to people who live in Wave 6 -- Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Texas, Utah, Washington and Wyoming. The agency continues to mail new cards nationwide to people who are new to Medicare.

If someone with Medicare says they didn't get a card after their mailing wave ends, you should instruct them to:
  • Call 1-800-MEDICARE (1-800-633-4227) where the federal CMS can verify their identity, check their address and help them get their new card.
  • Continue to use their current card to get health care services until they get their new card.
Check this website as the mailings progress. Continue to direct Medicare patients to  for information about the mailings and to sign up to get email about the status of card mailings.  Information on the transition to the new MBI:
Federal CMS re-calculates 2017 MIPS final scores and extends targeted review deadline until Oct. 15, 2018

Recently, the federal CMS released physician's 2017 Merit-based Incentive Payment System (MIPS) performance feedback and upon release opened the targeted review process. Based on the AMA flagging calculation error concerns and the initial targeted review requests the agency received, they have revised the scoring logic and re-issued the 2017 MIPS final scores for the physicians who were impacted by the following identified issues:
  • Application of the 2017 Advancing Care Information (ACI) and Extreme and Uncontrollable Circumstances hardship exceptions.
  • The awarding of Improvement Activity credit for successful participation in the Improvement Activities (IA) Burden Reduction Study.
  • Incorrect attribution of the All-Cause Readmission (ACR) measure to certain physicians and group practices MIPS final score.
Additionally, to ensure the federal CMS maintains the budget neutrality that is required by law under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), some physicians will see slight changes in their payment adjustment because of the reapplication of budget neutrality.

The revisions were made to the performance feedback on the Quality Payment Program website on Sept. 13, 2018. The AMA encourages physicians and groups to sign in to the Quality Payment Program website as soon as possible to review their performance feedback. If you believe an error still exists with your 2019 MIPS payment adjustment calculation, the targeted review process is available for you.

To offer additional time for physicians, groups, and APM entities and their participants to access and review their performance feedback, the federal CMS is extending the targeted review deadline to Oct. 15, 2018 at 8 p.m. (EDT). The agency also has several resources available on the Quality Payment Program Resource Library to help physicians and practices understand their performance feedback and the targeted review process. 

If you are in need of additional assistance, please reach out to the Quality Payment Program Service Center by phone at 1-866-288-8292, (TTY) 1-877-715-6222 or by email at, or contact your local technical assistance organization for no-cost support.
Colorado QPP Coalition - September Fast Facts

Targeted review deadline extended!

MIPS ECs (including support staff, authorized third-party intermediary (includes those subject to the APM scoring standard)) may request a targeted review of their performance feedback and final score. If you believe an error has been made to your payment adjustment calculation, contact the QPP service center at 1-866-288-8292. If they're unable to resolve your issue, ECs have until Oct. 15, 2018 (by 8 p.m. EDT) to request a targeted review.

Comments have been submitted for the following changes under the 2019 Proposed Rule
  • Adding four new clinician types: Physical Therapists, Occupational Therapists, Social Workers and Clinical Psychologists. 
  • Adding a third component to the low volume threshold. 
    • In addition to billing $90,000+ to Medicare Part B and seeing 200+ beneficiaries; ECs must also provide 200+ covered services. ECs meeting ONE of the three have the ability to participate voluntarily.
  • Maintaining the five point small practice bonus, but moving it from the final calculation to the Quality performance category score. 
    • Proposed changes to the performance threshold = 30 points to avoid a negative payment adjustment, and 80 points to receive an exceptional performance bonus.
Proposed performance category changes include:
  • Quality: Weight changes to 45 percent and the addition and removal of measures. Adding 10 new quality measures and retiring 34 measures. 
  • Improvement Activities: Weight stays at 15 percent. One activity is being proposed for removal and six activities added.
  • Promoting Interoperability: Weight stays at 25 percent weight, but proposing doing away with the base, performance and bonus measures. Security risk analysis will be the only base measure. All measures will be mandatory and scored on a sliding scale based on performance with a maximum of 100 total points. 
  • Cost: Weight changes to 15 percent, and while adding eight new episode-based measures.
Act now to upgrade your EHR to 2015 certified version!

Eligible clinicians and groups that participate in MIPS are required to use certified EHR technology if they want to report measures in the Promoting Interoperability performance category. In 2018, this requirement can be met with either 2014 or 2015 Edition CEHRT or a combination of the two. In 2019, only 2015 Edition CEHRT can be utilized; so now is the time to upgrade.
New QPP resources listed below were released in August. Take some time to review them on the QPP Resource Library.
Proposed 2019 Medicare QPP rule: Top 7 things doctors should know

Physicians have weighed in on the Centers for Medicare and Medicaid Services' plans to modify the Quality Payment Program (QPP) that is intended to transform the Medicare payment system by linking payment updates to physicians' efforts to improve quality of care, reduce health care spending and participate in alternative payment models. The AMA is calling on the federal CMS to cut red tape that makes it difficult for physicians to succeed in QPP.

The comments on QPP came as part of a broader, 136-page letter that also addresses the agency's proposed changes to the 2019 Medicare physician fee schedule. These detailed comments on the rule elaborate on an earlier letter in which the AMA and Colorado Medical Society were two of 170 organizations representing physicians and other health care stakeholders that objected to the federal CMS plan to collapse payment rates for physician evaluation-and-management (E/M) office visit services over concern about its potential impact.

On the QPP portion of this 1,500-plus page rule, the AMA has compiled seven things that physicians should know about the changes that the federal CMS should make to its proposed rule. Read these seven things here.
2018 Heal the Healer Symposium - Oct. 13 in Pueblo

Join the Pueblo Department of Public Health and Environment, Personal Impact Foundation and Pueblo County Medical Society for a transformational, interactive experience that will give you practical tools for establishing personal wellness and controlling stress to go beyond surviving to thriving in your career.

When: Saturday, Oct. 13, 2018, 8 a.m. to 3 p.m. MDT

 Pueblo Community College, Fortino Ballroom, 900 W. Orman Ave., Pueblo, CO 81004

Why you should attend: Providers are in crisis in our community, state and around the nation. ACT NOW! Come hear what the experts say about it, including world-renowned speaker, Dan Diamond, MD, adept in crisis management and how providers can thrive under pressure! You'll leave with tools to ensure you can be your best selves for the good of your families and patients.

Target audience: Physicians, dentists, nurse practitioners, physician assistants, and spouses/guests

Cost: $50 per person which includes 4 AMA PRA Category 1 Credits™, breakfast, lunch, amazing speakers and free giveaways!

Register here.
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