September 2016

2017 Quality Payment Program: Pick your pace

Andrew Slavitt, acting administrator of the Centers for Medicare and Medicaid Services, announced in a Sept. 8 blog post that the agency will heed concerns expressed by the American Medical Association, the Colorado Medical Society and other physician organizations about the proposed start date for performance reporting by physicians under the new payment systems created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

In a draft regulation issued last April, the federal CMS proposed to require physicians to begin reporting under the Merit-based Incentive Payment System (MIPS) or through the advanced alternative payment model (APM) option on Jan. 1, 2017, even though final regulations promulgating MACRA's sweeping payment system changes would not be issued until the fall.

The agency has now announced that the final MACRA regulation will allow physicians to pick their pace of participation for the first performance period staring Jan. 1. During 2017, eligible physicians and other clinicians can choose one of three MIPS reporting options to avoid a penalty in 2019, or choose the option of participating in an advanced APM.

Test the Quality Payment Program
Participate for part of the calendar year
Participate for the full calendar year
Participate in an Advanced Alternative Payment Model in 2017

These options, and other supporting details, will be described fully in the final rule. Read more about the AMA and Colorado Medical Society working for you on www.CMS.org.

2015 QRUR reports are now available

On Sept. 26, the Centers for Medicare and Medicaid Services made available the 2015 Annual Quality and Resource Use Reports (QRURs) to every group practice and solo practitioner nationwide.

Groups and solo practitioners are identified in the QRURs by their Medicare-enrolled Taxpayer Identification Number (TIN). The 2015 Annual QRURs show how groups and solo practitioners performed in 2015 on the quality and cost measures used to calculate the 2017 Value Modifier. For physicians in groups with 2 or more eligible professionals and physician solo practitioners that are subject to the 2017 Value Modifier, the QRUR shows how the Value Modifier will apply to payments under the Medicare Physician Fee Schedule for physicians who bill under the TIN in 2017.

For more information, visit the 2015 QRUR and 2017 Value Modifier webpage. Authorized representatives of groups and solo practitioners can access the 2015 Annual QRURs on the CMS Enterprise Portal using an Enterprise Identify Data Management account with the correct role. For more information on how to access the 2015 Annual QRURs, visit the How to Obtain a QRUR webpage. For questions, contact the Physician Value Help Desk at 888-734-6433 (select option 3) or [email protected].

Workers' compensation: Dates for fall listening and rule update seminars

The Division of Workers' Compensation has announced the dates, locations and times for the division's upcoming annual fall Listening and Rule Update seminars. The registration process is now online. Click here to sign up for any of the dates listed below. Each person attending must register online for the specific event they will be attending. As always, these seminars are free.

There will be two telephonic presentations this year: one geared toward the payer and one geared toward the providers. Be sure to sign up for the provider teleconference so DWC can address questions within the context of your role in the system.

Grand Junction
Sept. 30, 8 a.m. - 1 p.m.
St Mary's Pavilion, East/West Conference Room
750 Wellington Av, Grand Junction, CO 81506

Colorado Springs
Oct. 21, 1 - 5 p.m.
Memorial Administrative Center, Class Room B
2420 E. Pikes Peak, Colorado Springs, CO 80909

Littleton
Oct. 28, 1 - 5 p.m.
Arapahoe Community College, Lecture Hall
5900 South Santa Fe Dr, Littleton, CO 80160

Aurora
Nov. 4, 1 - 5 p.m.
Community College of Aurora, Rotunda
710 Alton Way, Aurora, CO 80230

Loveland
Nov. 8, 1 - 5 p.m.
Medical Center of The Rockies, Longs Peak Room
2500 Rocky Mountain Av, Loveland, CO 80538

Provider Teleconference
Nov. 30, 2016, 1 - 5 p.m.

Don't forget! ICD-10 grace period ends Oct. 1

The Centers for Medicare and Medicaid Services updated a FAQ on requirements related to the ICD-10 transition, reminding physicians that the flexibility program, announced July 2015, is ending Oct. 1. Click here to read the FAQ.

The federal CMS announced the flexibility program last year after pressure from the American Medical Association and other organizations. The flexibility period ensured that doctors would not be penalized with claims denials or quality-reporting penalties as long as they selected a diagnosis code from the right family of codes for the first year of implementation.

Are you ready for the changes coming to Colorado Medicaid (Health First Colorado) Oct. 31?

As part of the Colorado Medicaid Management Innovation and Transformation (COMMIT) project, the Department of Health Care Policy and Financing will be launching several new provider-facing systems on Oct. 31. To help providers prepare, they published a multi-section guide. Access the guide here.

Sign up for their email distribution list by clicking here to receive important information specific to your provider type or business.

Guidelines for providing patients with disabled parking placards or plates

Practitioners (MD, DO, physical therapists and chiropractors) who can sign forms providing the public with the ability to obtain permanent or temporary disabled parking placards or plates need to be sure they are aware of the laws so as not to be in violation.

Mindy Siegel, MD, an orthopedic surgeon and member of the Colorado Advisory Board for Persons with Disabilities, reminds physicians that not everyone qualifies. "If you are giving these to every person with a disability you may be in violation of the law. Someone who is blind, has PTSD, has a hearing impairment or those with some developmental disabilities (autism) would need to be accompanied by a physical disability that limits their ability to walk."

Disabled parking plates and placards are only available to those who have at least one of the following:

Concern	Examples
Mobility - cannot walk more than 200 feet without stopping to rest	Polio, ALS, muscular dystrophy
Assisted mobility - uses mobility aids (wheelchairs, walkers, canes, scooters, crutches)	Lower limb amputations, ALS, multiple sclerosis, lower limb surgery
Respiratory - must have a spirometer measurement of less than 1 liter or artificial oxygen tensions less than 60 mmhg on room air	COPD, cystic fibrosis
Oxygen	Uses portable oxygen 24 hours a day
Cardiac - class 3 or class 4 according to standards set by the American Heart Association	Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases.
Other persons who are severely limited in their ability to walk due to an arthritic, neurological or orthopedic condition	Muscular dystrophy, multiple sclerosis, lower limb amputations, cerebral palsy, strokes

Many physicians are under the impression that anyone with a disability qualifies -- or that they qualify for a three-year minimum placard. It's also important to know the timelines and assign the appropriate type of placard:

Placard Type	Length
Permanent	A condition that is not expected to change within a person's lifetime, given the current state of medical or adaptive technology
Extended	A condition that is not expected to change within 30 months after the issuance of an identifying figure, given the current state of medical or adaptive technology. Renewed every third year.
Temporary (lower extremity surgery)	A condition that is expected to last less than 30 months after the issuance of an identified plate or placard, given the current state of medical or adaptive technology. 90-day renewal
Short Term	A condition that is not expected to last more than 90 days after the issuance of a placard. Can be renewed one time.

Practitioners are certified under penalty of perjury. Providers who knowingly misuse or make false statements to help someone obtain or retain a plate or a placard may be fined up to $500,000 for a class 4 felony or $1,000 for a class 1 misdemeanor.

Siegel also discourages providers from leaving signed forms on your counter or giving them out prior to a surgery. If the person cancels their surgery but obtains a placard anyway -- or gives the signed form to a friend to obtain a plate or placard -- the provider is liable by law. Local DMV offices have appointments that are easy to schedule and remove the need to stand in line for those who cannot.

"Place yourself in the position of those who are disabled," she writes. "Often there are no spaces available to those with disabilities, especially those that need extra space for loading and unloading wheelchairs."

Contact the Colorado Advisory Council for Persons with Disabilities with any questions or concerns at [email protected].

In This Issue

MACRA update

2015 QRUR reports now available

Workers' comp listening and rule update seminars

ICD-10 grace period

Big changes coming to Colorado Medicaid

Guidelines for providing patients with disabled parking placards or plates