The Centers for Medicaid and Medicare Services (CMS) has relaxed MIPS reporting requirements during the current coronavirus pandemic. Exceptions and extensions have been outlined for providers participating in Medicare quality reporting programs. 

Changes to MIPS Data Submission Deadlines

CMS policy exceptions and extensions currently apply to data submission deadlines in April and May of this year. Submission is optional based on the ability of a clinic to report. Further, CMS will not use data that is reflected in services provided between the beginning of the year (January 1) and June 30th of this year. This is for the purpose of Medicare quality reporting and value-based purchasing programs. The result is a reduction of data collection and reporting burden during the coronavirus pandemic.

Understanding the Importance of Quality CMS MIPS Required Data

Practioners and CMS alike understand the importance of quality data. As such, there is a known factor that data during this time may not be truly in sync with accuracy when it comes to cost, readmission and patient experience. The organization would much prefer accurate, quality information be submitted at a stretch deadline than have data that reflects the nature of the current coronavirus (COVID-19) pandemic.

Who Is Impacted by CMS MIPS Reporting Relief Efforts?

The efforts put forth by the Centers for Medicaid and Medicare Services apply across the spectrum of healthcare providers. Includes are clinicians, providers, hospitals, and facilities who are participating in quality reporting programs.

During this time of pandemic it is globally understood that resources are being stretched and the ability to ensure that patients become healthier is as important as any other task or requirement. With hospitals subject to filling and clinicians and other providers having to rely on new technology such as telemedicine to stay as close as possible to their patients, CMS understands the necessity to relax rules across the board.

CMS Programs with Reporting Policy Exceptions

The below tables indicate where the extreme and uncontrollable circumstances policy exceptions and extensions have been made. Please note that this document is subject to change and update. Given the fluidity of the information and pandemic situation, it is recommended to bookmark the Coronavirus website www.cornavirus.gov

Provider Programs2019 Data Submission2020 Data Submission
Quality Payment Program -Merit-based Incentive Payment System (MIPS)Deadline extended from March 31, 2020 to April 30, 2020.

MIPS eligible clinicians who have not submitted any MIPS data by April 30, 2020 will qualify for the automatic extreme and uncontrollable circumstances policy and will receive a neutral payment adjustment for the 2021 MIPS payment year.

CMS is evaluating options for providing relief around participation and data submission for 2020.
Medicare Shared Savings Program Accountable Care Organizations (ACOs)

 

Hospital Programs2019 Data Submission2020 Data Submission
Ambulatory Surgical Center Quality Reporting ProgramDeadlines for October 1, 2019 – December 31, 2019 (Q4) data submission optional.

If Q4 is submitted, it will be used to calculate the 2019 performance and payment (where appropriate). If data for Q4 is unable to be submitted, the 2019 performance will be calculated based on data from January 1, 2019 – September 30, 2019 (Q1-Q3) and available data.

CMS will not count data from January 1, 2020 – June 30, 2020 (Q1-Q2) for performance or payment programs. Data does not need to be submitted to CMS for this time period.

* For the Hospital-Acquired Condition Reduction Program and the Hospital Value-Based Purchasing Program, if data from January 1, 2020 – March 31, 2020 (Q1) is submitted, it will be used for scoring in the program (where appropriate).

CrownWeb National End-Stage Renal Disease (ESRD) Patient Registry and Quality Measure Reporting System
ESRD 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

 

Post-Acute Care Programs2019 Data Submission2020 Data Submission
Home Health Quality Reporting ProgramDeadlines for October 1, 2019 – December 31, 2019 (Q4) data submission optional.

If Q4 is submitted, it will be used to calculate the 2019 performance and payment (where appropriate).

Data from January 1, 2020 – June 30, 2020 (Q1-Q2) does not need to be submitted to CMS for purposes of complying with quality reporting program requirements.

* Home Health and Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data from January 1, 2020 through September 30, 2020 (Q1-Q3) does not need to be submitted to CMS.

*For the Skilled Nursing Facility (SNF) Value-Based Purchasing Program, qualifying claims will be excluded from the claims-based SNF 30-Day All-Cause Readmission Measure (SNFRM; NQF #2510) calculation for Q1-Q2.

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