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Tuesday, November 15, 2016 - 11 to 12:30 pm MDT
MACRA Quality Payment Program Final Rule Webinar
Presented by CMS
Join CMS for a webinar on the MACRA
final rule with comment
period. The webinar will give an overview of the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) incentive payment provisions under MACRA, collectively referred to as the Quality Program Program.
Target Audience: Medicare Part B Fee-For-Service clinicians, office managers and administrators; state and national associations that represent healthcare providers and other stakeholders.
Thursday, December 8, 2016 - 1 to 2 pm MDT
2016 Meaningful Use End of Year Review
Presented by Health Technology Services
Join Patty Kosednar, HTS Consultant, to review what you need to know and do to successfully attest to Meaningful Use for the 2016 reporting year. We will also provide an overview of the alignment/conversion of the existing MU program into MACRA/MIPS for 2017.
Review the requirements for 2016 MU reporting
options if CMS approves a 90 day reporting period for 2016
Share the list of tasks and deadlines needed to meet the requirements
Provide suggestions on how to overcome obstacles in reporting
Overview of MU program alignment with MACRA/MIPS for 2017
* Open Q&S Session
Did You Miss our Latest October Webinars - PQRS QRUR The Value Modifier Report Card?
On October 25, Sharon Phelps, Mountain-Pacific Quality Improvement Consultant, shared the basics of the PQRS Quality and Resource Utilization Report (QRUR).
Access the presentation slides and recording.
Do you have a webinar topic you would like us to present? Email your hot topic to Deb Anderson
See our upcoming webinars.
|Top 5 What You Need to Know Now!
Meaningful Use (MU): What are the Alternate Exclusions Available in 2016 for Meaningful Use?
In 2015, CMS published a final rule that specifies criteria that eligible professionals (EPs), eligible hospitals (EH) and critical access hospitals (CAHs) must meet in order to participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs for 2015 through 2017.
The final rule included alternate exclusions for certain objectives and measures in 2015 and 2016 where there is not a Stage 1 measure equivalent to the Modified Stage 2 (2015 through 2017) measure, where a menu measure in any stage is now a requirement, or where additional technologies or CEHRT modules are required.
Below is information on the available alternate exclusions for 2016 -
- Eligible Providers, Hospitals and Critical Access Hospitals that were scheduled to be in Stage 1 in 2016 may claim an alternate exclusion for Objective 3 - Computerized Provider Order Entry, Measures 2 and 3 (lab and radiology orders), or choose the modified Stage 2 objective and measures.
- Eligible hospitals and CAHs that were scheduled to be in Stage 1 in 2016, or were scheduled to demonstrate Stage 2 but did not intend to select the Stage 2 electronic prescribing (eRx) objective, may claim an alternate exclusion for Objective 4 - eRx or choose the modified Stage 2 objective.
- Providers scheduled to be in Stage 1 and Stage 2 in 2016 may claim an alternate exclusion for the Public Health Reporting measure(s) that might require acquisition of additional technologies that they did not previously have or did not previously intend to include in their activities for meaningful use. EPs may claim an alternate exclusion for Measure 2 (syndromic surveillance) and Measure 3 (specialized registry reporting). Eligible hospitals may claim an alternate exclusion for Measure 3 (specialized registry reporting).
- Review this CMS fact sheet for an overview and more details about alternate exclusions for certain objectives and measures in 2016.
The information above is for the "alternate exclusions" available this year. There are still possible exclusions for some of the measures (in addition to the alternate exclusions). To check out the exclusions available on each measure, click on the individual measure link on the following spec sheets -
The 2015 Annual QRURs were released on September 26, 2016. The 2015 Annual QRURs show how physician groups and physician solo practitioners performed in 2015 on the quality and cost measures used to calculate the 2017 Value Modifier as well as their 2017 Value Modifier payment adjustment. Access and review your 2015 Annual QRUR now to determine whether you are subject to the 2017 Value Modifier payment adjustment.
An Enterprise Identity Management (EIDM) account with the appropriate role is required for groups and solo practitioners to obtain their 2015 Annual QRURs. The
How to Obtain a QRUR webpage
contains instructions for signing up for the appropriate role in EIDM and instructions for accessing the QRUR.
Physician groups or physician solo practitioners may request an informal review of perceived errors in their 2017 Value Modifier calculation during the informal review period of September 26, 2016 through November 30, 2016 at 11:59 pm at Eastern Time. Additional information about the 2015 Annual QRURs and how to request an informal review is available on the
2015 QRUR and 2017 Value Modifier webpage
Clinical Quality Measures (CQMs): Did you know your software vendor may not be certified to report all Clinical Quality Measures (CQMs) electronically?
During the certification process, certified EHR vendors do not have to certify to report all of the clinical quality measures - this applies to both hospital and provider EHRs. This becomes a determinant factor if your organization or provider decides to move ahead with electronic report of CQMs.
If you do not have direct access to your software vendor or are curious to know, you can find the CQMs that your vendor is certified to at the Certified Health IT Product website (maintained by ONC) at
You will need to be able to search for your vendor by CEHRT number (easiest way) or name and version number. If it is not an integrated system, you may need this information from each of the pieces and parts.
If you'd like assistance, please don't hesitate to
Soon, CMS will begin distributing letters to each Eligible Professional who did NOT satisfactorily report 2015 PQRS quality measures. The purpose of this letter is to inform each individual or group who will be receiving a 2.0% reduction on all their 2017 Medicare Part B Physician Fee Schedule payments. The good news is the majority of eligible professionals successfully reported PQRS in 2015 so fewer of you will be receiving this letter than last year! This letter pertains
only to the PQRS program
and, if you receive this letter, you could also be subjected to additional negative adjustments under the Value Modifier program.
If you do receive one or more of these letters, here are the important things to know.
FIRST - d
etermine who is affected by the payment reduction.
Look at the number in the upper left-hand corner of the letter. Is it just the Tax Identification Number (TIN) or does it also contain the TIN plus the National Provider Identifier (NPI) number for a TIN/NPI combination number?
- If a letter is sent to individual EPs, a TIN/NPI combination number will be listed and the adjustment applies only to the individual EP associated with the TIN/NPI noted within the letter and not the clinic or facility.
- If the letter is sent to PQRS group practices, a TIN only is listed and the adjustment applies to all EPs who have reassigned their billing rights to the TIN.
understand your options.
- Submit an informal review if you believe the negative payment adjustment is being applied in error. This would be an appropriate step if you submit 2015 PQRS quality measures and are getting a negative payment adjustment. Review the PQRS feedbacks to learn more about why CMS is giving this adjustment.
- Deadline to submit the informal review is November 30.
- CMS will investigate and issue a decision within 90 days of receipt.
- Informal review requests are submitted via a web-based tool at Quality Reporting Communication Support Page.
Please note - this link is for an Informal Review for PQRS only. To submit an Informal Review for the Value Modifier, please use the Informal Review option located in EIDM in the PV-PQRS section.
- If you did not submit 2015 PQRS quality measures, there are no hardship exemptions for the PQRS negative payment adjustment.
prepare for 2016 PQRS quality measure submission.
- If you will be getting a negative payment adjustment in 2017, you will want to review your approach to reporting PQRS quality measures for 2016 to avoid negative payment adjustments in the future. Our staff is available to discuss your strategy and answer your questions.
Take a look at our new
HTS PQRS Blog which
provides timely information and suggestions for PQRS reporting throughout the process. Subscribe now to receive the most current PQRS blog information in your email. Once you subscribe, you can add your comments, questions or advice that can help others through the PQRS "adventure".
HIPAA: Looking to take advantage of cloud solutions and stay HIPAA compliant?
With the proliferation and widespread adoption of cloud computing solutions, HIPAA covered entities and business associates are questioning whether and how they can take advantage of cloud computing, while complying with the HIPAA Rules.
In response, the HHS Office for Civil Rights (OCR) has issued important new guidance to assist organizations, including cloud service providers (CSPs), in understanding their HIPAA obligations. The guidance presents key questions and answers to assist HIPAA-regulated CSPs and their customers in understanding their responsibilities under the HIPAA Rules when they create, receive, maintain, or transmit electronic protected health information using cloud products and services.
ISC2 Certified Health Care Information Security and Privacy Practitioner with Health Technology Services, if you need help with your Privacy and Security needs.
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Health Technology Services is a department of Mountain-Pacific Quality Health Foundation, QIN-QIO for Alaska, Hawaii, Montana and Wyoming. Together we can help you use technology to deliver the quality care your patients deserve!
Thank-You and Happy Thanksgiving!
Health Technology Services
Mountain-Pacific Quality Health
Contact HTS at (406) 457-5897
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