On June 9, 2020, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced new redistributions from the Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers who participate in those programs. As a result, HHS plans to distribute approximately $15 billion to Medicaid and CHIP program participants who have not received a payment from the Provider Relief Fund General Allocation.

The COVID-19 pandemic is becoming far more than just a public health crisis. The effects of the virus have proven to be long reaching, transforming one crisis into many. As businesses across the country were forced to close their doors during the initial outbreak, the country experienced a record surge in unemployment due to the resulting economic fallout. While the economic crisis has received much of the attention, there is a third crisis that has been less discussed—the litigation crisis—which has already begun and is predicted to last for several years.

For years, one of the biggest complaints that providers have had about the Promoting Interoperability program has been that they are unable to obtain direct messaging addresses for their coordinating providers. When I speak with practices, the number one reason I hear for why their Support Electronic Referral Loops by Sending Health Information and Support Electronic Referral Loops by Receiving and Incorporating Health Information measures are scoring low is that they cannot get others to exchange CCDAs with them because of this difficulty. CMS has heard this complaint but is still requiring that providers electronically exchange care coordination information. These two measures combined are worth 40% of a clinician or group’s total Promoting Interoperability score.

IMPORTANT NOTICE: As of April 26, 2020, CMS has suspended the Advanced Payment Program, effective immediately, and is reevaluating the Accelerated Payment Program. CMS Press Release on Program Suspension The current COVID-19 pandemic has impacted specialty practices across the country and around the world, resulting in low patient volumes and decreased revenues. As part of the CARES Act, the Centers for Medicare & Medicaid Services (CMS) authorized relief to providers in the form of Advanced Medicare Payments. However, it is important for providers to note that this Advance Payment Program is an interest free loan, not a grant.

The COVID-19 pandemic’s arrival in the United States began at a time when many healthcare providers would normally be submitting their 2019 MIPS attestations. This yearly process, however, had to be set aside as lockdown orders were implemented in a vast majority of states and social distancing rules had to be observed. In order to offer some relief from the current pressure being experienced by providers during this public health emergency, the Centers for Medicare and Medicaid Services (CMS) has enacted a number of new measures to reduce the chaos of 2019 MIPS attestation.

In mid-August, the Centers for Medicare & Medicaid Services (CMS) released its 2020 Quality Payment Program Proposed Rule Overview. This document outlines changes to Quality Payment Program (QPP) policies that will take effect in the upcoming 2020 year, as well as proposed changes for 2021. It is also a summarization of the far more detailed (and roughly 1700 page long) CY 2020 Revisions to Payment Policies document. One section that is likely to be of the most interest to healthcare providers deals with new modifications to the Merit-Based Incentive Payment System (MIPS). In this article, we will be looking at these MIPS 2020 changes, particularly those that are of concern to specialty healthcare practices in fields such as dermatology, ophthalmology, plastics/aesthetics and orthopedics.

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Remember learning how to ride a bike? Although it was slightly nerve-wracking when your parents took the training wheels off, it was also empowering. You had moved beyond just getting the hang of things and were really making progress. You could travel past the end of the block and explore new possibilities. In some ways, this is similar to what healthcare organizations are going through with the 2019 Outpatient Prospective Payment System (OPPS) Rules.