April 19, 2018: National Advocacy Update

Registration is required for groups that intend to use the CMS Web Interface and/or administer the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for Merit-based Incentive Payment System (MIPS) survey for 2018.

Only groups of 25 or more eligible clinicians that have registered can report via the CMS Web Interface. Groups that participate in MIPS through the qualified registry, qualified clinical data registry, or electronic health record (EHR) data submission mechanisms do not need to register. For 2018, only groups of two or more eligible clinicians that have registered can participate in the CAHPS for MIPS survey. Visit the Quality Payment Program website to register. You will need a valid Enterprise Identity Management (EIDM) account. If you do not have an EIDM account, please create one as soon as possible. The registration period is from April 1–June 30, 2018.

Please note: If your group was registered to participate in MIPS in 2017 via the CMS Web Interface, CMS automatically registered your group for 2018. You may edit or cancel your registration at any time during the registration period. Automatic registration does not apply to the CAHPS for MIPS survey. For more information, visit the Quality Payment Program Resource Library to review resources on the CAHPS for MIPS Survey and the CMS Web Interface.

CMS is conducting the 2018 Burdens Associated with Reporting Quality Measures Study, as described in the Quality Payment Program (QPP) Year 2 final rule. Clinicians and groups who are eligible for the Merit-based Incentive Payment System (MIPS) that participate successfully in the study will receive full credit for the 2018 MIPS Improvement Activities (IA) performance category.

The study runs from April 2018 to March 2019. Clinicians do not need any outside knowledge of MIPS to participate in the study; rather the study team is interested in learning more about clinicians' experience participating in MIPS. Applications will be accepted through April 30, 2018. Clinicians will be notified in spring of 2018 if selected.

CMS is conducting this study to:

• Examine clinical workflows and data collection methods using different submission systems.
• Understand the challenges clinicians face when collecting and reporting quality data.
• Make future recommendations for changes that will attempt to eliminate clinician burden, improve quality data collection and reporting, and enhance clinical care.

Participants will have to meet the following requirements in order to complete the study and receive full IA credit. For participants reporting as a group, their entire group will receive credit. For participants reporting as individuals, only the participating clinician will receive credit.

• Complete a 2017 MIPS participation survey in April/May 2018.
• Complete a 2018 MIPS planning survey September/October 2018.
• The Study team will invite selected participants to join a virtual 90-minute focus group between November 2018 and February 2019.
• Meet minimum requirements for the MIPS Quality performance category by submitting data for at least three measures in the MIPS Quality performance category, as required for 2018 MIPS participation.

The data submitted must:

• Include one outcome measure.
• Be submitted to CMS by the final MIPS reporting deadline (March 31, 2019).
• Be submitted through any method accepted under MIPS for year 2 of the Quality Payment Program (2018).

Clinicians can apply to participate in the study here.

Many medical practices, first responders, surgery centers and hospitals are experiencing difficulties in patient care due to acute shortages of injectable opioids, including hydromorphone, morphine and fentanyl.

The American Society of Health-System Pharmacists and the University of Utah Drug Information Service have developed a fact sheet outlining best practices for management and conservation, including information on inventory control, pharmacy operations and patient safety.

The Office of the National Coordinator for Health IT (ONC), a federal agency that regulates health information technology, recently released a guide to help patients better understand how to get, check and use their health records.

Under the Health Insurance Portability and Accountability Act (HIPAA), patients have the right to see and obtain a copy of their health record from most health insurance plans and health care providers, including, physicians, clinics, hospitals, pharmacies, labs and nursing homes. Federally certified EHRs (most EHRs in use today), must provide a way for patients to access and send their records. However, these "patient portals" can be challenging to use or only provide a subset of the patient's health record.

The AMA has alerted this discrepancy between HIPAA's requirements and what is actually available via the EHR to the Office of Civil Rights (OCR), the federal agency that regulates HIPAA. The AMA is urging health IT vendors and policymakers to improve the usability and interoperability of EHRs, for both physicians and patients, to enable secure and seamless access to medical information.

Health record availability and access is also a measure in CMS' EHR Incentive Programs. To stay compliant with federal regulation, help patients engage with their records, and improve your chance for success in the QPP, the AMA recommends contacting your EHR vendor and requesting tools, tips or further information on enabling patient access through your EHR.

Last week, the House Energy and Commerce Subcommittee on Health and the Senate Health, Education Labor and Pensions (HELP) Committee held legislative hearings to consider policies to combat the opioid epidemic. This was the Energy and Commerce Committee's third hearing this year on this topic. The latest hearing focused on 34 bills pertaining to the Medicare and Medicaid programs, which were in addition to the 30 bills discussed at the previous hearings.

The HELP Committee released a bipartisan discussion draft entitled the "Opioid Crisis Response Act of 2018" prior to its hearing, which contains multiple proposals to address the opioid crisis across several agencies. The HELP Committee is expected to mark up this bill on April 24 and the Energy and Commerce Committee is expected to consider opioid legislation later this spring.

Additionally, on April 11, the House Committee on Ways and Means issued an opioid white paper analyzing the responses it received to a request of information. The white paper quoted part of AMA's response regarding how traditional provider payment systems frustrate efforts to combat the opioid epidemic by not supporting non-face-to-face services. (The AMA's response to the Committee's request for information was covered in the March 22 issue of Advocacy Update.)

• April 19, 2018: Advocacy spotlight on AMA, specialty societies ask CMS to reduce 2018 MIPS reporting period 
• April 19, 2018: State Advocacy Update