CMS issues 2020 Quality Payment Program rule
The Centers for Medicare & Medicaid Services (CMS) published its final 2020 rule (PDF) for the fourth year of the Quality Payment Program, which affects physician anesthesiologists and practices that participate in either the Merit-based Incentive Payment System (MIPS) or in Advanced Alternative Payment Models (APMs).
CMS finalized several provisions for the MIPS 2020 performance period (2022 payment period):
- The performance threshold for 2020 is 45 MIPS Total Points - up from 30 MIPS Total Points in 2019. Eligible Clinicians (ECs) or practices that fail to participate when required, or fail to meet the 45-point threshold, may incur up to a negative 9 percent payment adjustment in 2022.
- Out of 100 MIPS points available, 45 percent will be allocated to Quality, 25 percent to Promoting Interoperability, and 15 percent each to Improvement Activities and Cost categories
- The MIPS Quality reporting rate threshold will increase from 60 percent of eligible cases per measure to 70 percent of eligible cases.
- CMS approved MIPS #477, Multimodal Pain Management as a MIPS measure in the Anesthesiology Measure Set starting in 2020.
ASA physician leaders and staff continue to review the QPP Final Rule (PDF) and will develop educational and implementation materials for members and their practices in the upcoming weeks. For more information on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), visit ASA's MACRA website. To check on MIPS eligibility, visit the CMS MIPS Participation Lookup Tool.
Review your NACOR dashboard
Remember to review your 2019 quality reports in the new NACOR dashboard. For practices that have uploaded a new data file, AQI encourages a member of your practice to review the NACOR dashboard as it allows you to monitor your providers' performance, as well as pinpoint any problems with the data and make necessary corrections prior to data submission deadlines. For more information, email askaqi@asahq.org.
Comment on ASA draft quality measures
The American Society of Anesthesiologists is seeking comments on draft quality measures currently under development by the Core Measure Development Group, under the direction of the Committee on Performance and Outcomes Measurement. The following quality measures are open for public comment through November 22.
• Prevention of Arterial Line-Related Bloodstream Infections
• Perioperative Anemia Management
• Intraoperative Antibiotic Redosing
• Ambulatory Glucose Management
The public comment period is an integral step in the measure development process and is an opportunity for relevant stakeholders to give their input and ensure the measures are meaningful and appropriate indicators of quality and are feasible for individuals and practices to collect.
To submit comments on the proposed measures, visit the 2019 Public Comment Period on Draft Measures page. For more information, email the Department of Quality and Regulatory Affairs (QRA) at
qra@asahq.org.
2019 NACOR registration
2019 Policies and Procedures
2019 Individual Quality Reporting consent form
2019 NACOR pricing (PDF)
2019 QCDR Measure Specifications (PDF)
2019 Recommended Improvement Activities
NACOR Data Definitions
Read past issues of
AQI's NACOR News.
Question: If a provider has left the practice half way through the year - does the practice need to report the provider's cases?
If the practice is reporting as a group and the provider performed cases in 2018, the practice needs to be reporting 60% of all eligible cases for that provider regardless if they are still at the practice or not as CMS is evaluating the data at the TIN level not the individual NPI. If the practice is individually reporting, the data will follow the provider's NPI.
Question: In regards to the reporting year on the AQI website it state to submit 60% of eligible cases and we understand it is not pick your pace but does this mean 60% of 2018 cases? Can you elaborate?
The 2018 MIPS reporting requirement is to report on 60% of the denominator eligible cases for 6 measures including 1 outcome measure for the 12 month reporting period (1/1/2018 - 12/31/18). For example, If your practice is reporting MIPS 76 - Prevention of Central Venous Catheter (CVC - Related Bloodstream Infections and places 75 central lines during 2018 your practice would need to report on 45 cases which is 60% of the eligible cases.
Question: Is it possible for all providers in a practice to be non-MIPS eligible and not required to submit data as individuals, but are eligible as a group?
Yes if the individual providers do not meet the 2018 MIPS participation criteria (billed $90,000 or less in Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries (including Railroad Retirement Board and Medicare secondary Payer) and have 200 or fewer Medicare Part B FFS beneficiaries) the practice can be MIPS eligible as a group if the group has billed $90,000 or more in PFS services furnished to Medicare Part B beneficiaries and have 200 or more Medicare Part B beneficiaries.