ONC-ACB Certification ID: 15.04.04.2705.Crit.04.00.1.191111 | Certification Date: Nov 11, 2019
MIPS Requirements for 2020

MIPS Requirements for 2020

2020 is coming to an end, but before the year is over, there are a few MIPS requirements that must be addressed. Please determine the correct course of action for your practice as soon as possible, as these requirements are time sensitive. As always, Criterions is happy to assist with guidance on these requirements, but only CMS can give definitive client specific clarifications.

By the end of the 2020 calendar year the following MIPS items MUST be completed:

Security Risk Analysis

A completed security risk analysis. The CMS issued tool can be found here.

Improvement Activities

Documenting and/or updating completed Improvement Activities. A full list can be found here.

Hardship Exemptions

Hardship Exemptions exist for practices under strain due to COVID, practice size, rural locations and other issues. Information about exceptions can be found here.

Hardship Exception Application must be completed by February 1, 2021.

2020 To Do List

2020 To Do List

As the final quarter of 2020 approaches, practices should take action on time-sensitive programs that will impact reimbursement in the future. Below is our "2020 To Do List" with details outlining the steps you need to take to achieve each item.

Check Your MIPS Numbers

October marks the last quarter that practices can begin to achieve compliance for certain MIPS categories in 2020:
Confirm submission method - If you submitted via registry in the past, and plan to submit via eCQMS, or are considering submitting through a registry for 2020, make sure you understand the allowed measures, costs, and outcomes.
• Practices should run their Promoting Interoperability and MU3 – Clinical Quality Measures reports every month to ensure practice is meeting requirements.
• Complete your Security Risk Analysis.
• Document progress on Improvement Activities.

For more information, read the MIPS 2020 and Criterions blog post.

Register for PAMA

The Centers for Medicare and Medicaid (CMS) currently requires all providers to use a Clinical Decision Support Mechanism (“CDSM”) to electronically validate advanced imaging orders using approved online guidelines. On January 1, 2021, imaging centers will not be reimbursed for orders that do not include this information so it is vital that ordering physicians be able to perform the validation without impacting their workflow.

Learn how to meet the AUC validation requirements under PAMA here. 

Purchase NYC and NY State Immunization Interface

With changes to MIPS, practices are now required to have live bidirectional interfaces with NYCIR and NYSIIS.

Why practices need it:
• These interfaces send immunizations for Adults and Children to the respective registry electronically in the new MIPS format.
• The old interface is no longer valid with new rules.
• Practices without the electronic interface cannot attest on MIPS for submitting to a public registry. This will affect MIPS compliance.
• Practices not in NYC must purchase a NYSIIS interface for immunizations for Adults and Children.
• Practices in NYC must purchase a NYC CIR interface for immunizations for Adults and Children.
• This MIPS interface sends the immunizations administered, as well as retrieves the patients current immunizations already administered by other physicians from the registry.

Contact support@criterions.com to purchase.

If you have any questions about the 2020 To Do List, fill out the form below and a member of our team will be in touch:

Appropriate Use Criteria (AUC) for Advanced Imaging

Appropriate Use Criteria (AUC) for Advanced Imaging

LogicNets and Criterions have joined forces to provide a solution for you to meet the AUC validation requirements under PAMA. The LogicNets AUC Solution is a cloud service that lets you easily confirm that an advanced imaging order for Medicare/Medicaid patients is appropriate based on your patient scenario. When done, it generates the new reimbursement codes CMS now requires with your imaging orders.

Why is AUC a Requirement?

The Centers for Medicare and Medicaid (CMS) currently require all providers to use a Clinical Decision Support Mechanism (“CDSM”) to electronically validate advanced imaging orders using approved online guidelines. On January 1, 2021 imaging centers will not be reimbursed for orders that do not include this information and so it is vital that ordering physicians be able to perform the validation without impacting their workflow.

About the LogicNets AUC Solution

The LogicNets AUC Solution is an affordable and secure online service for rapidly evaluating a patient scenario and either validating that an order is appropriate or recommending appropriate alternatives. The solution draws on CMS-qualified guidelines developed by Intermountain Healthcare. It can run in the background when integrated with an EHR and automatically switches to an interactive visual mode to collect clinical information from you to complete the validation. The solution provides a unique visual diagnostic pathways view of the guidance, making it easy for you to indicate key factors and be aware of and evaluate alternative approaches if necessary.

How to Get the Service

In order to get the AUC Solution, simply go to LogicNets.com/AUC. You can read more about the solution there and you can gain access to the service by clicking on the “Sign Up” button. Be sure to enter “Criterions” in the space for additional information to indicate that you will be using the service in conjunction with Criterions software. Once you have filled in your basic information, LogicNets will create an account for you and contact you with instructions on how to access.

Questions about the AUC solution for advanced imaging? Fill out the form below:

MIPS Monthly Checklist

MIPS Monthly Checklist

Use the checklist below to ensure you are staying on track for the best MIPS reporting possible. Be sure to review your MIPS numbers monthly. For more information, please review the MIPS criteria found here.

  • Check Promoting Interoperability - Ensure you are meeting measure thresholds.  For all measures, higher percentages are better.

 

  • Check Clinical Quality Measures MU3 - Most measures, with the exception of 122v7 and 156v7, seek the highest percentage of patients meeting the measure. Measures 122v7 and 156v7 seek the lowest percentage of patients.

 

  • Document Improvement Activities - If changes or work have been done to meet the criteria of an improvement activity, document the work in case of an audit.

 

  • Complete Security Risk Assessment (if not previously completed) - The Security Risk Assessment must be completed at least once during the reporting period. If the report has not been completed, begin documentation.

For any other questions regarding MIPS, contact us using the form below:

MIPS 2020 and Criterions

MIPS 2020 and Criterions

While there is much uncertainty today, not only in the medical world, but the world at large, we are preparing for the resumption of life post pandemic. As of now, MIPS reporting will still be required for 2020. While we do not know if the requirements will change due to the pandemic, we are going off of the assumption that the rules will be enacted as initially created, meaning practices must report on Quality Measures, Promoting Interoperability, and Improvement Activities in the beginning of 2021. Below is our MIPS 2020 and Criterions guide that will help you fulfill MIPS requirements using Criterions EHR.

If you have any questions, please complete the form below:

Request a Demo!