Quality Payment Program Modified Due to COVID-19 Outbreak (1)

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What is the Quality Payment Program(QPP)?
The Quality Payment Program is the payment
reimbursement procedure for the clinicians which
ensures better payments with the least paperwork
to all the medical service providers. Its aim is
to improve medical services and ensure timely
payments. Its objective is to give focus on the
quality of the treatment to the patients. It has
two participation tracks- The merit-based
incentive payment System   (MIPS) and the
Alternative Payment Method (APM). In the first
one i.e. MIPS, the payment is based on the
performance and it is adjusted according to the
performance of the clinicians. In APS, the
payment system is developed by the Centre for
Medicare and Medicaid Services (CMS) in a
customized manner to provide incentives to the
medical service providers who provide high
quality and high-value care. It focuses on
specific clinical conditions and cares about
episodes and populations. 
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Modification of QPP due to COVID-19

• We all know that the whole world is going through
  crises due to the outbreak of deadly pandemic-
  COVID-19 or Coronavirus. Therefore keeping in
  view the urgent requirement of all the medical
  staff in treating the patients and handling the
  situation, the CMS has granted exceptions and
  extensions from all the reporting requirements
  and data submissions for the Medicare Quality
  Payment Program. Some of the modifications which
  have been implemented are
• The situation has become extreme and
  uncontrollable due to which the data submission
  deadline was extended from March 31 to April 30,
  2020.  
• The clinicians who did not submit the data by
  April 30 will be eligible to receive a neutral
  payment for the 2021 MIPS payment year.
• Clinicians will automatically get their final
  score equal to their performance threshold. This
  will result in a neutral payment adjustment on
  the covered professional services furnished in
  the year 2021 MIPS payment year. 

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• The Individual, group or virtual group MIPS
  eligible medical providers who could not submit
  their MIPS data by the deadline will qualify for
  the 2019 automatic extreme and uncontrollable
  circumstances policy which has arisen due to the
  COVID-19 pandemic.
• If an extreme and uncontrollable circumstance
  application has been submitted between April 3
  and April 30, 2020, citing COVID-19 and it has
  been approved by CMS then it will override any
  previous data submission by the clinicians.
• Also, the hospitals in the program will not be
  required to submit the data to the CMS for
  January 1 through June 30, 2020, and the CMS will
  not count this period for payment or the
  performance program. 

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Why These Modifications are Necessary?

• The CMS is basically trying to reduce the
  bureaucratic efforts for the health care
  professionals so as to reduce the hurdles. This
  can, in turn, help them to prioritize the
  patients and care for them instead of involving
  themselves in paperwork. Due to the current
  pandemic, most of the medical staff is working
  double shifts and additional paperwork will only
  increase their woes. So keeping in mind all the
  factors, the deadlines have been extended to show
  them support and to free them from unavoidable
  work. The extension will also ensure that the
  Medical staff is protected and taken care of. 
• The entire world is facing severe crises due to
  the spread of COVID-19 and the hospitals all
  around the world are full of patients who need
  constant care and treatment from the doctors. The
  data collected during this time may not reflect
  the true performance of the doctors and even the
  hospitals are so overburdened that it is not
  possible for them to record and submit all the
  data. Thousands of patients are dying each day
  and it is not in the hands of the doctors to
  protect them. There is no medicine, treatment or
  vaccination for the disease as a result of which
  the doctors can only try to treat them and care
  for them. 

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• All the people are advised to strictly stay at
  home and all the unnecessary and routine
  appointments of the doctors have been delayed to
  focus on the COVID-19 patients. Virtual
  consultations are given preference over direct
  consultations so as to avoid the spread of the
  disease. 
• This scenario has made it important for the
  service providers and the payers to band together
  to adjust and cooperate with each other and face
  this tough situation together. This extension of
  deadlines is a positive step by the CMS to
  provide a new health care environment and give
  its contribution to the medical providers. 
• Further with Medeye LLC, the hospitals and
  doctors can leave all the work of documentation
  with the experts from the firm and concentrate on
  giving maximum care and support to the patients
  without having to worry about the reimbursements.
  The team of experts at the medical billing
  company can streamline all the bills and submit
  them to ensure maximum reimbursement at the
  earliest.