Risk Management and Compliance

News

2017 MIPS Feedback Reports with 2019 Payment Adjustment Information Now Available; File Targeted Reviews with CMS by September 30

CMS has released 2017 MIPS feedback reports, which include information on 2019 payment adjustments. You must log into the Quality Payment Program (QPP) site to access the report. CMS will not distribute the reports through email or U.S. mail. Log into your portal on the QPP site using your Enterprise Identity Management (EIDM) credentials.

ASCRS, AAO, and OOSS Release Specialty-Specific Guidelines for Ophthalmic Instrument Cleaning and Sterilization

The American Society of Cataract and Refractive Surgery (ASCRS), the American Academy of Ophthalmology (AAO), and the Outpatient Ophthalmic Surgery Society (OOSS) have released new specialty-specific guidelines for the sterile processing of ophthalmic surgical instruments. This document makes evidence-based recommendations regarding issues that may be unique to the cleaning and sterilization of intraocular instrumentation.

CMS Announces Medicare Advantage (MA) Plans May Begin Using Step Therapy in January 2019

CMS has announced it is eliminating an existing prohibition for MA plans to use a cost containment strategy known as “step therapy” for drugs administered in the physician’s office or facility. Step therapy requires physicians to prescribe an insurer’s preferred treatment first, and only covers more expensive treatments if the patient does not respond to the initial treatment.

CMS Extends 2017 MIPS Submission Deadline

Physicians Have Until April 3 at 8 p.m. EDT to Submit Data and Avoid the 4% Penalty in 2019

Today, CMS announced it is extending the deadline to submit 2017 MIPS performance data to April 3, 2018, at 8:00 p.m. EDT.

CMS Releases 2019 ICD-10CM Updates with Significant Changes to Ophthalmology Codes

This week, the Centers for Medicare and Medicaid Services (CMS) released the ICF-10CM updates for FY 2019. The 2019 ICD-10-CM codes are to be used for patient encounters and discharges occurring from October 1, 2018 through September 30, 2019. Below is a list of the 2019 ICD-10 code changes that impact ophthalmology.

2019 ICD-10 Ophthalmic Code Changes

A92.5 Zika virus disease

  • Adds note: Excludes 1: congenital zika virus disease (P35.4)

C43 - Malignant melanoma of skin - new category

CMS Releases Proposed Rule for 2019 ASC Payment

2019 AMBULATORY SURGICAL CENTER (ASC) PAYMENT SYSTEM AND QUALITY REPORTING (ASCQR) PROGRAM
PROPOSED RULE RELEASED

2019 ASC Conversion Factor Projected at $46.500 for
ASCs Meeting Quality Reporting Requirements

Interpreting MACRA Technical Corrections to Facilitate Your Success

Recent advocacy by ASCRS•ASOA and the medical community has prompted Congress to enact technical corrections to the MACRA statute last week. These changes mean that physicians and practices will have additional time to implement the MIPS program and will be able to succeed in the coming years.

New Medicare Cards MBI Look-Up Tool Available Through Your MAC

As of this week, all Medicare Administrative Contractors (MAC) secure portals Medicare Beneficiary Identifier (MBI) look-up tools are available for use. This tool is used to look up MBIs for Medicare patients when they have lost or do not have their Medicare card. To access the tool, you will need to sign up for your MAC’s portal.

New MIPS Resources for 2018

New MIPS Resources: 2018 MIPS Small Practice Guide; EyeTalks Podcast on Key Changes to MIPS for 2018 and New Details on the Four MIPS Categories

Now Available: 2017 Quality Payment Program Performance Feedback and Targeted Review Video Demonstrations

Last week, CMS released the following demonstration videos on how to access your Merit-Based Incentive Payment System (MIPS) feedback report and how to request a targeted review: