CMS provides reporting exemptions for Medicare payment programs

CMS is waiving reporting requirements and extending data submission deadlines for providers and hospitals participating in Medicare quality programs, the agency said March 22.

The move aims to provide relief for workers who are on the front lines of the COVID-19 outbreak.

"For those programs with data submission deadlines in April and May 2020, submission of those data will be optional, based on the facility's choice to report," CMS said. "In addition, no data reflecting services provided January 1, 2020 through June 30, 2020 will be used in CMS' calculations for the Medicare quality reporting and value-based purchasing programs. This is being done to reduce the data collection and reporting burden on providers responding to the COVID-19 pandemic."

Thirteen things to know:

For the Quality Payment Program, Merit-based Incentive Payment System, and the Medicare Shared Savings Program Accountable Care Organizations:

1. The 2019 data submission deadline is extended from March 3, 2020, to April 30, 2020.

2. Clinicians who are eligible for MIPS who don't submit MIPS data by April 30 will receive a neutral payment adjustment for the 2021 MIPS payment year.

3. The 2020 data submission deadline is under evaluation. 

For the following 11 hospital programs: 

  • Ambulatory Surgical Center Quality Reporting Program
  • CrownWeb National ESRD Patient Registry and Quality Measure Reporting System
  • End-Stage Renal Disease Quality Incentive Program
  • Hospital-Acquired Condition Reduction Program
  • Hospital Inpatient Quality Reporting Program
  • Hospital Outpatient Quality Reporting Program
  • Hospital Readmissions Reduction Program
  • Hospital Value-Based Purchasing Program
  • Inpatient Psychiatric Facility Quality Reporting Program
  • PPS-Exempt Cancer Hospital Quality Reporting Program
  • Promoting Interoperability Program for Eligible Hospitals and Critical Access Hospitals

4. Submission of fourth-quarter (October to December 2019) data is optional.

5. Should fourth-quarter data be submitted, where appropriate, CMS will use it to calculate the 2019 performance and payment.

6. If fourth-quarter data is unavailable, the 2019 performance will be calculated using data from January to September 2019, for the first through third quarters.

7. The 2020 data submission deadline will not include data from January through June 2020 for performance or payment programs. Data doesn't need to be submitted for this time frame.

8. Specifically, for the Hospital-Acquired Condition Reduction Program and the Hospital Value-Based Purchasing Program, any data submitted from January to March 2020 will be used for scoring in the program, where appropriate. 

For the following six post-acute care programs: 

  • Home Health Quality Reporting Program
  • Hospice Quality Reporting Program
  • Inpatient Rehabilitation Facility Quality Reporting Program
  • Long Term Care Hospital Quality Reporting Program
  • Skilled Nursing Facility Quality Reporting Program
  • Skilled Nursing Facility Value-Based Purchasing Program

9. The 2019 data submission for fourth-quarter (October to December 2019) data is optional. 

10. Should fourth-quarter data be submitted, where appropriate, CMS will use it to calculate the 2019 performance and payment. 

11. Data from January through June 2020 doesn't need to be submitted to CMS to comply with quality reporting program requirements.

12. Specifically, for the Home Health and Hospice Consumer Assessment of Healthcare Providers and Systems survey, data from January through September 2020 doesn't need to be submitted to CMS. 

13. Qualifying claims for the Skilled Nursing Facility Value-Based Purchasing Program will be excluded from the claims-based SNF 30-day all-cause readmission measure calculation for the first and second quarters of this year.

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