Washington Watch Weekly - June 26, 2020 | ASCRS
Washington Watch

Washington Watch Weekly - June 26, 2020

CMS Officially Announces Relief for Providers Participating in the QPP Program in 2020

On June 24, in response to the COVID pandemic, CMS officially announced flexibilities for providers participating in the Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) in 2020:

  • Clinicians significantly impacted by the public health emergency may submit an Extreme & Uncontrollable Circumstances Application to reweight any or all of the MIPS performance categories. If you request relief via the application, you will need to provide a justification that your practice has been significantly impacted by the public health emergency. Individual clinicians and group practices have until December 31, 2020 to complete the hardship application.
  • CMS plans on providing physicians with a couple of options on the hardship exemption application. For example, a practice may submit a hardship application and indicate that they do not want to be scored on Cost and Quality and have their score calculated based on just Promoting Interoperability and Improvement Activities. Alternatively, practices may submit a hardship application and opt-out of all four performance categories and be held harmless from a 2022 payment adjustment. Submitting any MIPS data to CMS will override the hardship exception application and physicians will be scored on their submission.
  • Reminder: In April, CMS added a new COVID-19 clinical trials improvement activity. There are two ways MIPS eligible clinicians or groups can receive credit for this new improvement activity:
    • A clinician may participate in a COVID-19 clinical trial and have those data entered into a data platform for that study; or
    • A clinician participating in the care of COVID-19 patients may submit clinical COVID-19 patient data to a clinical data registry for purposes of future study.

Please Note: CMS has cited COVID-19 as an example of a circumstance that could qualify for this application in 2020. However, CMS has not yet declared COVID-19 as a triggering event for the automatic exception for 2020, as it did for 2019.

For More Information:

HHS Updates the Provider Relief Fund Webpage, Portal, and FAQ’s

Health and Human Services (HHS) has recently updated the Provider Relief Fund Webpage, Portal, and FAQ’s.

The most recent FAQ additions or clarifications include:

  • Time Period for Use of Funds – new FAQ
    • HHS states that it expects providers “will only use Provider Relief Fund payments for as long as they have eligible expenses or lost revenue.” and that if, “at the conclusion of the pandemic, providers have leftover Provider Relief Fund money that they cannot expend on permissible expenses or losses, then they will return this money to HHS.”

FTC Finalizes Amendments to the Contact Lens Rule

On June 23, the Federal Trade Commission (FTC) announced they approved the new final rule that amends the Contact Lens Rule. The changes go into effect 60 days after publication in the Federal Register Notice, which is expected shortly. ASCRS worked with the ophthalmic community and opposed the new requirements, arguing they were unnecessary and burdensome.

Specifically, the new rule requires prescribers to request that their patients confirm they have received their prescription. Prescribers must maintain proof that they satisfied the confirmation of prescription release requirement for at least three years.

MedPAC Releases June Report to Congress

The Medicare Payment Advisory Commission (MedPAC) released its latest report to Congress last week. This year’s report includes seven chapters:

  • Realizing the promise of value-based payment in Medicare: An agenda for change
  • Challenges in maintaining and increasing savings from accountable care organizations (ACOs)
  • Replacing the Medicare Advantage quality bonus program
  • Mandated report: Impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees
  • Realigning incentives in Medicare Part D
  • Separately payable drugs in the hospital outpatient prospective payment system (OPPS)
  • Improving Medicare’s end-stage renal disease (ESRD) prospective payment system (PPS)

Amongst other recommendations, the Commission recommends replacing the Medicare Advantage quality bonus program with a value incentive program that could save approximately $94 billion over 10 years and reduce premiums for all Medicare beneficiaries.

SBA Releases Interim Rule with Guidance on PPP Loan Forgiveness; Implements Flexibility Changes

On June 22, The Small Business Administration (SBA) released an updated Interim Final Rule with Guidance, which implements the flexibility changes that were included in the Paycheck Protection Program (PPP) Flexibility Act of 2020.

The program allows qualifying employers with up to 500 employees to apply for a forgivable loan to cover payroll costs over a maximum of 24 weeks.

Specifically, the PPP Flexibility Act extended to 24 weeks the covered period in which funds must be utilized; extended the 5-year loan maturity date; decreased the percentage of loan funds that must be used for payroll costs to 60%; and included additional exemptions and safe harbors from reductions in loan forgiveness.

The interim final rule includes the following:

  • Updates the timing of when borrowers may apply for loan forgiveness
  • Clarifies borrowers can apply for loan forgiveness prior to the end of the covered period.
  • If the borrower received a PPP loan before June 5, they may elect to use the original eight-week period.
  • The borrower may submit loan forgiveness applications after they use the PPP funds – even if it is before the end of the covered period.
  • If the borrower has reduced any employee’s salary by more than 25%, the borrower is required to apply that salary reduction for the full eight weeks or 24-week period.

CMS Creates New Office of Burden Reduction and Health Informatics Office

On June 23, the Centers for Medicare & Medicaid Services (CMS) announced the creation of a new Office of Burden Reduction and Health Informatics to oversee the administration’s efforts to reduce regulatory burden. The centerpiece of the burden reduction work by CMS over the past three years has been the Patients over Paperwork initiative. The new office will also have some responsibilities related to health informatics.

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