Risk Management and Compliance

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•ASOA has updated the Medicare Participation Kit for 2019 to help members make decisions about their participation in Medicare. The kit provides details about Medicare in 2019, such as the 0.25% update factor, which was reduced from the MACRA-instituted 0.5% level as an offset for the Bipartisan Budget Act. In addition, the kit outlines the three options for Medicare participation: participating provider, non-participating provider, and private contracting.

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.

ASCRS•ASOA members have exclusive access to a new overview guide of the 2019 QPP, which includes MIPS and Advanced Alternative Payment Models (APM) and impacts 2021 payments.

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.

The U.S. Food and Drug Administration is alerting healthcare professionals and patients not to use drug products intended to be sterile that are produced and distributed by Pharm D Solutions LLC, Houston, Texas, due to lack of sterility assurance.

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.

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

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: