Newsletter for Members and Partners July 03, 2019
QPP Tool Now Includes First Snapshot of 2019 for QPs
NAACOS July 16 Webinar Spotlights Medicaid ACOs
NAACOS Supports Chronic Care Management Bill
BPCI-A Issues Letter to Participants Regarding MSSP Overlap
Trump Administration Releases Executive Order on Price Transparency
MSSP Application Period Opened July 1
Senate Committee Passes Health Bill
MIPS Audits Begin
New B-CAPA Reports for MSSP and NextGen ACOs
CMS ISSUES TEMPLATE BENEFICIARY NOTIFICATION LETTER
NAACOS has been informed that CMS has made available a template beneficiary notification letter to all ACOs, accessed through the ACO-MS. NAACOS has reached out to CMS to urge the agency to provide further clarification as soon as possible regarding when the notifications must be distributed and in what manner. In the meantime, we encourage ACOs to contact their ACO Coordinator for more details until further guidance is provided by CMS. NAACOS also recently submitted a letter to CMS urging the agency to delay this notification requirement given the very late issuance of template language. We are disappointed CMS did not delay this requirement, and we will continue to press CMS to provide additional guidance. NAACOS will keep members updated as we receive additional information from CMS.
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| United Medical, LLC Bear, DE |
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QPP TOOL NOW INCLUDES FIRST SNAPSHOT OF 2019 FOR QPs
CMS has updated the Quality Payment Program (QPP) Participation Status Tool to include 2019 Qualifying APM (Alternative Payment Model) Participant (QP) and participation status for the first snapshot. As a reminder, QPs are eligible for the 5 percent APM incentive bonus and exempt from the Merit-Based Incentive Payment System (MIPS). ACOs can view APM and QP participation status at the individual (National Provider Identifier) and APM entity level. To view APM entity level information, CMS instructs ACOs browse by Tax Identification Numbers (TINs) affiliated with the ACO entity and access the details screen to view the eligibility status of clinicians based on their NPIs. If you have questions email [email protected]. For more information on which ACO models qualify as Advanced APMs, as well as how CMS calculates QP status for 2019, please access The ACO Guide to MACRA.
NAACOS JULY 16 WEBINAR SPOTLIGHTS MEDICAID ACOS
A number of state Medicaid programs have implemented value-based payment arrangements, including some states that focus their programs around ACOs. While accountable care programs vary across states, there are some common Medicaid-specific challenges and approaches. NAACOS will review state Medicaid ACO initiatives during a 75-minute webinar, Understanding the Medicaid ACO Landscape, on July 16 from 12:30 – 1:45 pm ET. This webinar will include a presentation by NAACOS consultant Judy Moore, who has worked with state and federal Medicaid programs for several decades, and it will also include individual ACOs sharing their own experiences and describing recent ACO developments in their state’s Medicaid programs. Register today for this webinar, which is a member benefit!
NAACOS SUPPORTS CHRONIC CARE MANAGEMENT BILL
A NAACOS-supported bill ( H.R. 3436) that removes the cost-sharing obligations from Medicare’s Chronic Care Management codes gained the approval of the House Ways and Means Committee on June 26. The codes, which pay for non-face-to-face care management, are an important part of coordinated care. NAACOS joined other stakeholders in a letter to committee leadership supporting the bill. Get more information on the codes, including CPT codes 99487, 99489, 99490, and 99491.
BPCI-A ISSUES LETTER TO PARTICIPANTS REGARDING MSSP OVERLAP
Recently the Innovation Center issued a notice to Bundled Payments for Care Improvement-Advanced (BPCI-A) participants regarding changes in the overlap policy for the Medicare Shared Savings Program (MSSP). The email notes the following:
For Model Year 1 and 2 reconciliation calculations, BPCI-A includes expenditures for items and services furnished to beneficiaries assigned to MSSP Tracks 1, 1+, 2, and Basic Track (levels A through E) and excludes from reconciliation calculations expenditures for items and services furnished to beneficiaries aligned to Enhance Track (formerly known as Track 3).
For Model Year 3 reconciliation calculations, BPCI-A will include expenditures for items and services furnished to beneficiaries assigned to MSSP Tracks 1, 1+, 2, Basic Track (levels A through E), and Enhanced Track. Therefore, BPCI-A will no longer exclude beneficiaries aligned to an MSSP track. CMS will continue to exclude beneficiaries aligned or assigned to an ACO participating in the Next Generation ACO Model, Vermont All-Payer ACO Model, and the Comprehensive End-Stage Renal Disease Care Initiative in tracks with downside risk for financial losses.
This is a departure from previous CMS policy, and NAACOS is disappointed to see CMS make this change. NAACOS will continue to advocate for overlap policies that prioritize the total cost of care models by giving precedence to those responsible for a patient’s total cost of care and health of the entire patient population.
| Welcome Business Partner | |
| Innovista Health Solutions Innovista Health Solutions is a single resource for physician integrated models to gain access to innovative technology, expert programs, actionable data insights, financial resources, and growth opportunities, to navigate and succeed in value-based and risk-based arrangements. innovista-health.com |
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TRUMP ADMINISTRATION RELEASES EXECUTIVE ORDER ON PRICE TRANSPARENCY
On June 24, President Donald Trump signed an executive order (EO) calling on federal agencies to draft regulations that require price disclosure within the health care industry. The order directs the Department of Health and Human Services (HHS) to issue rules requiring hospitals to disclose prices negotiated with health plans, as well as mandating that providers and insurers inform patients of their out-of- pocket costs before receiving care. The order also directs federal health care agencies to develop a Health Quality Roadmap to align and improve reporting on data and quality measures across Medicare and other federal health programs. It’s expected that HHS will begin sending these proposed rules to the White House for review in the coming weeks and months. Some of these proposals may also be incorporated into the 2020 hospital outpatient and physician payment rules which are expected to be published in early July.
MSSP APPLICATION PERIOD OPENED JULY 1
CMS is now accepting applications for ACOs interested in joining the MSSP starting January 2020. Only ACOs who filed a Notice of Intent to Apply (NOIA) can submit an application, and there is no requirement to submit an application after submitting the NOIA. The application period opened July 1 and will close July 29 at noon ET. CMS’s requests for information will be issued in mid-August, mid-September, and early October. As with the July 1 application cycle, ACOs will have additional time to add participants and correct participant agreements beyond the initial application period. CMS has developed an “Application Toolkit” to assist ACOs through the process.
| Welcome Associate ACO Member | |
| Statera Network Dothan, AL |
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