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Centers for Medicare & Medicaid Services Quality Payment Program. Small Practices Newsletter
Quality Payment Program Small Practices Newsletter: October 2024

The Quality Payment Program (QPP) Small Practices Newsletter is a monthly resource that provides small practices (15 or fewer clinicians) with program updates, upcoming QPP milestones, and resources to support their continued participation and success in QPP. We send this newsletter on the second Tuesday of each month.

Please share this newsletter with your fellow clinicians and practice staff and encourage them to sign up [ https://public.govdelivery.com/accounts/USCMS/subscriber/new?topic_id=USCMS_12879%2F&utm_source=newsletter&utm_medium=email&utm_id=newsletter_june2023&utm_content=smallpracsignup ] to receive this monthly resource.

*At-a-Glance: Required and Recommended Activities for Successful Participation in QPP *

Each month, we share required and recommended activities for small practices to support their successful participation in QPP. The activities follow a rolling quarter approach, letting you see activities for the previous month, the current month, and the following month.

Small Practices October Graphic

*In This Issue:                                                                                 *


* *Hot Topics: What You Need to Know*
* 2023 Performance Year Change Healthcare Cyberattack Reweighting Requests Will Be Accepted Through Friday, October 11, 2024 [ #link_1 ]
* REMINDER: 2023 Targeted Review Closes This Friday, October 11, 2024 [ #link_2 ]
* 2025 Virtual Group Election Period Now Open [ #link_3 ]
* Second Snapshot of 2024 Qualifying Alternate Payment Model (APM) Participant (QP) Status and APM Participation Data Now Available in QPP Participation Status Tool [ #link_4 ] [ #_QP_Determinations_Available ]
* New Links on the Electronic Clinical Quality Improvement (eCQI) Resource Center [ #link_5 ]
* REMINDER: 2024 MIPS Value Pathways (MVPs) Registration Open [ #link_6 ]_ _
* Relevant Resources [ #link_7 ]

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2023 Performance Year Change Healthcare Cyberattack Reweighting Requests Will Be Accepted Through Friday, October 11, 2024

We recognize that some clinicians and groups affected by the Change Healthcare cyberattack may not have been able to submit a Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances (EUC) Exception application for the 2023 performance year before the April 15, 2024 deadline. As a result, we’re allowing clinicians, groups, subgroups, virtual groups, and APM Entities to submit a request for reweighting of one or more MIPS performance categories under our EUC Exception policies at 42 CFR 414.1380(c)(2) [ https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-414/subpart-O#p-414.1380(c)(2) ] and 42 CFR 414.1317(b)(4) [ https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-414/subpart-O#p-414.1317(b)(4) ] solely on the basis of the Change Healthcare cyberattack, for the 2023 performance year now through *October 11, 2024, at 8 p.m. ET*.

Any clinician, group, subgroup, virtual group, or APM Entity that wasn’t able to submit their MIPS data solely because of the Change Healthcare cyberattack can request reweighting.

IMPORTANT: Because the Centers for Medicare & Medicaid Services (CMS) is reopening the window for requesting reweighting of one or more MIPS performance categories for the 2023 performance year in response to the Change Healthcare cyberattack, CMS will only approve applications citing this cyberattack as the basis for requesting reweighting under the MIPS EUC Exception policies. Any applications submitted for reasons outside of the Change Healthcare cyberattack will be denied.

*How Can I Request 2023 Performance Year Performance Category Reweighting?*

Due to technical limitations, we’re unable to reopen the 2023 performance year MIPS EUC Exception application form in our system, while the performance year 2024 MIPS EUC Exception application is open. Because of these technical limitations, we’re allowing the 2023 performance reweighting requests under our EUC Exception policies to be submitted through the MIPS Targeted Review form until October 11, 2024, at 8 p.m. ET. You can access this form by signing in to the QPP website [ https://qpp.cms.gov/login ].

The MIPS EUC Exception application form currently accessible when you sign in to the QPP website [ https://qpp.cms.gov/login ] is for the 2024 performance year application only. Don’t use the Exception application form to request reweighting for the 2023 performance year.

Please review the 2023 MIPS EUC Reweighting Requests for Change Healthcare Cyberattack Extension Guide (PDF, 675KB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3023/PY2023%20MIPS%20EUC%20Reweighting%20Requests%20for%20Change%20Healthcare%20Cyberattack_Extension%20Guide.pdf ] for step-by-step instructions with screenshots.

*What If We Already Submitted Data?*

In accordance with our MIPS reweighting policies for individual clinicians, groups, subgroups, and virtual groups, we won’t reweight any performance category for which we’ve received data. If we received data for a MIPS performance category, we’ll calculate a score for that performance category. (Refer to 42 CFR 414.1380(c)(2) [ https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-414/subpart-O#p-414.1380(c)(2) ].)

If a MIPS eligible clinician is scored on 2 or more performance categories, we’ll calculate a MIPS final score in accordance with our weighting policies. If a MIPS eligible clinician is scored on fewer than 2 performance categories, then they’ll receive a final score equal to the performance threshold.

In accordance with our EUC policies for APM Entities, data submission for an APM Entity won’t override performance category reweighting for all 4 MIPS performance categories. (Refer to 42 CFR 414.1317(b)(4) [ https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-414/subpart-O#p-414.1317(b)(4) ].) If we receive an EUC Exception application for an APM Entity for the 2023 performance year and we reweight all 4 MIPS performance categories, the MIPS eligible clinicians in the APM Entity will receive a 2023 MIPS final score equal to the performance threshold and a neutral MIPS payment adjustment in the 2025 MIPS payment year.

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REMINDER: 2023 Targeted Review Closes This Friday, October 11, 2024

The last day to submit a targeted review request is *Friday, October 11, 2024, at 8 p.m. ET*. You should _only_ submit a targeted review request if you believe an error has been made with your 2023 MIPS performance feedback and 2025 MIPS payment adjustment. Sign in [ https://qpp.cms.gov/login ] to review your feedback and/or to submit a targeted review request.

*When to Request a Targeted Review*

If you believe there’s an error in the calculation of your MIPS payment adjustment factor(s), you can request a targeted review *now until October 11, 2024, at 8 p.m. ET*.

For example:


* Data were submitted under the wrong Taxpayer Identification Number (TIN) or National Provider Identifier (NPI).
* You have Qualifying APM Participant (QP) status and shouldn’t receive a MIPS payment adjustment.
* Performance categories weren’t automatically reweighted even though you qualify for reweighting due to extreme and uncontrollable circumstances.

*Note: *This isn’t a comprehensive list of circumstances. If you have questions about whether your circumstances warrant a targeted review, please contact the QPP Service Center [ https://cmsqualitysupport.servicenowservices.com/ccsq_support_central ].

*How to Request a Targeted Review*

You can access your MIPS final score and performance feedback and request a targeted review by:


* Signing in [ https://qpp.cms.gov/login ] using your Health Care Quality Information Systems (HCQIS) Access and Roles Profile (HARP) credentials (Accountable Care Organization Management System [ACO-MS]) credentials for Shared Savings Program ACOs; these are the same credentials that allowed you to submit your 2023 MIPS data.
* Clicking “Targeted Review” on the left-hand navigation.

CMS generally requires documentation to support a targeted review request, which varies by circumstance. A CMS representative will contact you about providing any specific documentation required. If the targeted review request is approved and results in a scoring change, we’ll update your final score and/or associated payment adjustment (if applicable), as soon as technically feasible. *Please note that targeted review decisions are final and _not_ eligible for further review.*

*Targeted Review Resources:*


* *2023 Targeted Review User Guide (PDF, 15MB)* [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2961/2023-Targeted-Review-Guide.pdf ] – Reviews the process for requesting a targeted review and examples of when you would or wouldn’t request a targeted review.
* *2025 MIPS Payment Year Payment Adjustment User Guide (PDF, 710KB)* [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2962/2025-MIPS-Payment-Adjustment-User-Guide.pdf ] – Reviews information about the calculation and application of MIPS payment adjustments, and answers frequently asked questions.

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2025 Virtual Group Election Period Now Open

The 2025 virtual group election period is now open. Solo practitioners and groups with 10 or fewer clinicians interested in this traditional MIPS participation option [ https://qpp.cms.gov/mips/virtual-group-participation?py=2025 ] can submit or modify their election for the 2025 performance period via MIPS_VirtualGroups@cms.hhs.gov.

The following elements must be included in an election: 


* Acknowledgment that a formal written agreement has been established between each TIN within the virtual group. 

* The name and contact information for the official virtual group representative. 

* The name and TIN for each practice, and all associated NPIs under each TIN. 

The election period closes on *December 31, 2024, at 11:59 p.m. ET*. 

For more information about virtual group participation and elections, please review the 2025 Virtual Group Toolkit (ZIP, 2MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3009/2025-MIPS-Virtual-Group-Toolkit.zip ]. 

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Second Snapshot of 2024 Qualifying APM Participant (QP) Status and APM Participation Data Now Available in QPP Participation Status Tool

CMS updated its QPP Participation Status Tool [ https://qpp.cms.gov/participation-lookup ] based on the second snapshot of APM data. The second snapshot includes data from Medicare Part B claims with *dates of service between January 1, 2024, and June 30, 2024*.  

The tool includes 2024 QP status [ https://qpp.cms.gov/apms/advanced-apms ] and MIPS APM participation status. 

To learn more about how CMS determines QP and the APM participation status for each snapshot [ https://qpp.cms.gov/apms/apm-determination-periods ], please visit the QPP website [ https://qpp.cms.gov/ ]. 

*What Action Do I Need to Take? *


* Log in to the QPP website and verify your Entity information.
* If your information is inaccurate on the QPP website, contact the QPP Helpdesk at QPP@cms.hhs.gov.

*How Do I Check My QP or APM Participation Status?* 

To view your QP or APM participation status: 


* Visit the QPP Participation Status Tool [ https://qpp.cms.gov/participation-lookup ]. 
* Enter your 10-digit National Provider Identifier (NPI). 

*What Does QP Status Mean?* 

If you qualify as a QP, this means you're: 


* Eligible for the 1.88% APM [ https://qpp.cms.gov/apms/overview ] incentive bonus; 
* Eligible for APM-specific rewards; and 
* Exempt from participating in MIPS [ https://qpp.cms.gov/mips/how-eligibility-is-determined ]. 

*Learn More* 

For more information on APMs, visit the QPP APM webpage [ https://qpp.cms.gov/apms/overview ]. For a 2023 and 2024 comprehensive list of APMs (PDF, 484KB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2647/2023and2024CompListofAPMs.pdf ], and additional materials, visit the QPP Resource Library [ https://qpp.cms.gov/resources/resource-library ].

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New Links on the Electronic Clinical Quality Improvement (eCQI) Resource Center

CMS has updated the Electronic Clinical Quality Improvement (eCQI) Resource Center [ https://ecqi.healthit.gov/ ].

To promote continuity and connections among CMS resources, the Eligible Clinician measure table [ https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ec-ecqms&global_measure_group=eCQMs ] on the eCQI Resource Center now has direct MIPS Quality ID links to the QPP website. 

QPP measure information includes:


* Information regarding the traditional MIPS quality reporting program
* Key measure IDs
* Specialty Measure Set

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REMINDER: 2024 MIPS Value Pathways (MVPs) Registration Open

The MIPS Value Pathways (MVPs) registration window is open for the 2024 performance year. Individuals, groups, subgroups, and APM Entities [ https://qpp.cms.gov/apms/mips-apms ] that want to report an MVP can register until *December 2, 2024, at 8 p.m. ET*.

NEW FOR 2024: To register, sign in to the QPP website [ https://qpp.cms.gov/ ] with your HARP account. This is different from the 2023 process of completing an Excel form and emailing the QPP Service Center.

Additional Resources


* 2024 MVPs Implementation Guide (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2778/2024-MVPs-Implementation-Guide.pdf ]
* 2024 MVP Registration Guide (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2750/2024MVPRegistrationGuide.pdf ]
* 2024 Explore MVPs [ https://qpp.cms.gov/mips/explore-mips-value-pathways?py=2024 ] 

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Relevant Resources

*2024 Small Practice Resources*


* How to Participate as a Group in MIPS (VIDEO) [ https://www.youtube.com/watch?v=dRNd-YMgbHc&list=LL&index=6&t=90s ]
* 2024 Small Practice Action Planning Tool (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2954/2024-Small-Practice-Action-Planning-Tool.pdf ]
* Introduction to 2024 Small Practice Action Planning Tool (VIDEO) [ https://youtu.be/4UBAW45RlHk ]
* 2024 MIPS At-A-Glance Reporting Options for Small Practices (PDF, 260KB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2929/2024-MIPS-At-A-Glance-Reporting-Options-for-Small-Practices.pdf ]
* 2024 MIPS Quick Start Guide for Small Practices (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2622/2024MIPSGuideforSmallPractices.pdf?utm_source=newsletter&utm_medium=email&utm_campaign=february+2024&utm_id=newsletter_february2024&utm_content=24mipsguidesp ]
* MIPS 2024 Small Practice Eligibility and Participation FAQs (PDF, 461KB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2729/2024-Small-Practice-Eligibility-FAQs.pdf ]
* Do I Need to Participate in MIPS? How to Check Eligibility Status (VIDEO) [ https://www.youtube.com/watch?v=rHoH4hJaetI ]
* Small Practices FAQs [ https://qpp.cms.gov/resources/small-underserved-rural-practices#:~:text=Service%20Center%20Ticket-,FAQs,-Am%20I%20eligible ]
QPP Footer 2023 [ https://qpp.cms.gov/resources/help-and-support ]


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