Tuesday 22 June 2021

Rules to Address QPP MIPS 2021 More Successfully

QPP MIPS 2021 reporting, MIPS score, Qualified Registries, MIPS consulting services, MIPS Quality Measures

QPP MIPS 2021 reporting is an opportunity to streamline revenue cycle management, and if medical practices want to take financial matters up a notch, they must be ready to report it with full force.

A better approach or to ensure success in this regard, most clinicians prefer MIPS consultants. What those experts do is devise a strategy first and then look at ways that maximize the final MIPS score.  

There is no doubt that clinicians do not have enough time to ponder upon the MIPS reporting strategies by themselves. For 2021, it is tougher due to the pandemic that is affecting lives in every way possible. Qualified Registries present a feasible solution in this regard, which we will discuss later in this article.

Start with Making a Concrete MIPS Data Submission Policy

If physicians want to receive incentives and $500 billion worth of the bonus pool, they must have a resourceful team at their end to take care of the administrative load. The reporting rules are simple. The four MIPS performance categories are there, upon which physicians will be judged for their quality care services.

Moreover, MIPS 2021 reporting strategy must take into consideration the percentage of each performance category. Because, if you or the MIPS consulting services on your behalf do not recognize the potential of each category, how would you invest efforts in the right direction?

Apart from making a suitable strategy, another factor that plays a crucial role in the success of data submission is the selection of the right MIPS Quality Measures.

Select the Right Specialty-Specific Measures

Condensing physicians’ performance into one measure seems complex, but if it is specialty-specific, it can drive high-quality outcomes for you. The matter of truth is relevant measures that add more meaning to the MIPS reporting process.

It also allows CMS (Centers for Medicare and Medicaid Services) to comprehend your quality-driven efforts more easily. These are generally defined by a specific data set, and each measure is catered to your expertise more efficiently.

So, if you report MIPS data with the specialty-specific measures, chances are you are more likely to gain more points.

With different or abrupt reporting measures, it is difficult for CMS to measure your performance of any sort. So, to avoid such a case, where there is a chance of minimizing score, the best strategy is to look into measures that relate to your medical expertise.

Professional MIPS consulting services often go for this strategy. They reflect on compiling data that adds to the physicians’ capabilities and help them generate more points in the end.

Consult a MIPS Qualified Registry for Stress-Free Reporting

If you want to succeed in QPP MIPS 2021, you must consult a MIPS consulting firm for a seamless process. It has many benefits, to say the least.

A MIPS eligible physician:

  • Does not have to keep an eye on the industry’s latest updates
  • Can focus more on their primary tasks
  • Can report relevant MIPS quality measures
  • Has the team at their disposal to compile data accurately
  • Has resources that perform all tasks on their behalf

Having said all that, medical practices can leverage the professional team of MIPS consultants without having to worry about MIPS reporting by themselves. These are just a few basic advantages that a medical practice can enjoy. However, on practical grounds, many things can be enhanced in terms of quality reporting with experts.

Conclusion

If you take care of these points for MIPS 2021 reporting and consult a MIPS Qualified Registry, you can streamline the whole data submission process. In the end, it is easier to target MIPS incentives and even bonuses just because you make the right choice.

Wednesday 5 May 2021

Why Choose A MIPS Qualified Registry for 2021 Data Submission?

 

MIPS 2021, MIPS Qualified Registry, QPP MIPS reporting, MIPS consultants, MIPS Incentives
Despite the hectic load from the corona pandemic, we all have made it to the MIPS 2021. This program can compensate for the lost revenue last year and eventually improve our reputation. So, we cannot take it lightly at any cost.

To assist this need, a MIPS Qualified Registry is, therefore, crucial for all medical practices to cater to the administrative load. It not only simplifies your data submission process but also helps do it efficiently. A few advantages that clinicians enjoy from consulting a CMS-approved registry is:

  •          Simplifying the requirement analysis and reporting process
  •          Staying on top of QPP MIPS reporting requirements
  •          Achieving financial goals in a systematic order

Timely MIPS data submission to CMS

Of course, the reporting process is less stressful when you have a team of professionals with you. You can read a few benefits of hiring a MIPS Qualified Registry in this article. So, let’s go through them and reach the final decision that why we need to consult professionals for our practice.

One Platform Suitable for All Requirements

A qualified registry makes MIPS reporting work a lesser hassle for medical practices. There is every reporting option available for all specialties so, you do not have to worry about anything. Quality, Promoting Interoperability (PI), Improvement Activities (IA), and Cost, physicians get solutions for everything.

On the flip side, a streamlined process that professionalMIPS consultants offer allows keeping track of performance easily.

Moreover, it is flexible to have all the data in one place as you can effortlessly set your score goals. Productivity improves, and you have a plan of action to follow through.

Find Specialty-Specific Measures

Surprisingly, MIPS Qualified Registry offers approximately 232 Quality measures to report to CMS. This number is a lot less when you choose to report through another method.

Thus, it is easier to find relevant measures as per your medical specialty with a Qualified Registry with so many options at your disposal. You can even customize your measure set, as you desire for maximum MIPS score.

Instant Assistance Whenever You Want

The MIPS reporting requires compliance with many requirements, and clinicians usually already got their hands full with work. In such a situation, a registry emerges as a knight in shining armor and aids in all ways possible.

Their team is always at your disposal if you face any difficulty understanding the requirements or their implementation. No doubt, their advice on measure selection and other matters benefits medical practice in the long run.

All their goal is to conduct a healthy discussion where a healthcare organization gets on the track of their financial goals efficiently. Plus, a reduced administrative load is a bonus.

Timely & Reliable MIPS reporting Services

CMS only approves those MIPS consulting agencies that have efficient resources and a qualified experienced team. Indeed, it is a smart choice to consult professionals as clinicians find solutions to their problems in one place.

For instance, many medical practices just want to avoid penalties. They do not aim to target MIPS incentives or a bonus pool of $500 million, whereas, some clinicians have totally opposite aspirations.

They don’t hesitate to target high rewards for their exceptional performance.

So, no matter the diverse reporting goals, a MIPS Qualified Registry assists your needs appropriately and on time.

Consistent Support 24/7

Whether you want technical support or a financial estimation for MIPS 2021, it is easier when you have an experienced team at your disposal. Simple math can be hectic sometimes, and here we are talking about a payment incentive program, where there is no room for any error or miscalculation. So, a lot is at the stake, such as payment adjustments and MIPS incentives.

A Qualified Registry generally works on the principle to aid eligible clinicians in their administrative load.

So, no matter if you have a question regarding what specialty-specific measure will be suitable for your practice or accurate documentation, your dedicated MIPS consultant will guide you throughout the journey. Thus, experience and quality work are needed that can help you align your documentation with your objectives. And, it can be found when you have a MIPS Qualified Registry with you.

Analyze Financial Consequences

If you report data through a MIPS Qualified Registry, you can estimate your financial implications long before the data submission deadline. Consequently, one can strategize accordingly to translate their goals into actionable measures.

It is like a blueprint that gives a layout to go through the maze easily. So, you can do all the math to perform well in MIPS 2021.

Access to Resourceful Reporting Tools

What if you get access to a tool that makes it easy to collect, manage, optimize, and transmit data? Usually, MIPS Qualified Registries use such tools for seamless performance measurement.

So, if you have outsourced your work to them, chances are you can receive high outcomes without any fuss.

A few examples of what you can do with technology incorporation in your MIPS data submission process are:

  •          Analyze claims to segment related measures
  •          Check performance thresholds
  •          Estimate MIPS score

Conclusion

A MIPS Qualified Registry opens so many doors of opportunities for a medical practice. There is so much at stake with the MIPS 2021 reporting, and any intentional negligence is no choice. Therefore, we suggest consulting professionals for a seamless and stress-free reporting process.

Wednesday 31 March 2021

Requirement Analysis of QPP MIPS 2021

QPP MIPS 2020 is officially over, and MIPS eligible clinicians such as Anesthesiologist, Cardiologists, Dermatologists, and others, can get started on the MIPS 2021.

There is no hurry in this matter, but it is better to comprehend the program. It will help MIPS Qualified Registries to see what they can offer to their clients. Moreover, clinicians can align their efforts as per the value-based incentive program requirements.

What does the Final Rule MIPS 2021 Says?

The QPP MIPS 2021 holds many levels, and to perform well as per the criteria, we should know about all the aspects.

  • MIPS Score Threshold
  • Performance categories weights
  • Minimum performance thresholds
  • APM scoring requirements
  • Hierarchy of MIPS 2021 scores

In this article, we would briefly go through each aspect to get grip on our MIPS 2021 strategies. Let’s get into it.

MIPS Score 2021

We have observed four significant changes for MIPS 2021 reporting. The performance threshold and category weights are changed. However, for this year, the corona pandemic has played a major role in administrating changes.

Thus, the scoring hierarchy will reflect on the quality. It is also to note that CMS (Centers for Medicare and Medicaid Services) has withdrawn the APM scoring thresholds.

An Insight into Performance Thresholds

Minimum Performance Threshold

In MIPS 2021, the performance threshold is set to be at sixty points. It means that eligible clinicians now have to score at least sixty to avoid penalties. Moreover, if they want to earn MIPS incentives, they must meet at least this performance threshold.

CMS suggested setting points at fifty points at first. However, after analyzing the 2019 MIPS data, they realized that clinicians could manage the performance threshold of sixty points easily.

Exceptional Performance Threshold

The threshold for exceptional performance does not change in 2021. It remained the same in 2020. 

Clinicians must achieve eighty-five points in order to get additional MIPS incentives and qualifications of a $500 million pool.  The more points you have, the more incentives you can get.

MIPS 2021 Category Weights

There are different MIPS reporting weights for different reporting frameworks. However, with MIPS 2021, we have the following percentages for the following changes.

For all eligible individuals, groups, and virtual groups, the performance weighs as follows.

  • Quality category: 40%
  • Promoting Interoperability (PI): 25%
  • Improvement Activities (IA): 15%
  • Cost category: 20%

We observe that the cost category has increased, and The quality category has decreased since last year. Whereas, PI and IA remained the same.

It is expected that in 2022, CMS would balance both categories (Cost and Quality) at 30%.

MIPS 2021 Scoring Hierarchy

The hierarchy will give an idea of what MIPS incentives to expect from eligible clinicians.

Clinicians must have an idea of what to expect in MIPS incentives in 2023.

There are four methods to participate in MIPS 2021 reporting as an individual, group, virtual group, and APM entity.

The following table will give you an idea of what we want to suggest here.


MIPS APM Participation

Participation Status

Participation Method

Eligibility

Participation Level

No

MIPS Participant

Standard

Yes

Individual, Group, Virtual Group

Yes

MIPS APM Participation

Standard

Yes

Individual, Group, Virtual Group*, APM Entity

APP

 MIPS 2021 Payment Adjustments

For the performance of the year 2021, the MIPS payment adjustment is set to be at nine percent, which can be from -9 to +9. 

In a real-time scenario, the adjustments are lesser than the actual 9%. CMS suggests that it can be up to 6.89% for clinicians who manage to receive 100 MIPS points. Here is to remember that these points are not guaranteed but just an estimation. The actual points are based on the submitted data by the MIPS eligible clinician or the MIPS Qualified Registry on their behalf.

The ultimate goal is to achieve budget neutrality.

Requirement Analysis 

For MIPS eligible clinicians to participate and be successful in the program, one must follow the following low-threshold volume criteria. 

Clinician must:

  • Have equal or more than $90K in Part B allowed charges for covered healthcare services
  • Provide healthcare to equal or more than 200 Part B enrolled beneficiaries
  • Provide equal or more than 200 covered professional care services under the Physician Fee Schedule (PFS)
MIPS eligible clinicians must know reporting data is inevitable, and to succeed in this program, one must start early to at least meet the standards.

From recent studies, we know that MIPS scores are above average.  Hence, the higher percentage of qualifying clinicians, the lower percentage of incentives they receive! In simple terms, the incentives are finite, and with more MIPS 2021 eligible clinicians qualifying for the bonus, lesser money will be distributed among all.

Thursday 11 February 2021

MIPS IA Requirements that Every Eligible Clinician Must Know

Medicare and Medicaid Services, healthcare services, revenue cycle management, QPP MIPS, MIPS eligible clinicians, Improvement Activities, MIPS reporting requirements, MIPS data submission, healthcare industry, MIPS score, MIPS Quality Measures, MIPS Qualified Registry, MIPS 2021

CMS (Centers for Medicare and Medicaid Services) highly regards the improvements activities in clinical practices. It adds value to the quality of healthcare services and eventually increases the performance of your revenue cycle. QPP MIPS, therefore, incentivizes all those MIPS eligible clinicians who pay attention to minor quality details while treating patients.

Today, we will review Improvement Activities (IA) reporting requirements in MIPS data submission to CMS.

IA Reporting Requirements 2021

As you know, reporting requirements change every year due to advancements in the healthcare industry, and for the 2021 performance year, IA weighs 15% of the total MIPS score. It is also to remember that there are no additional reporting requirements under the APM Performance Pathway (APP).

What IA Data is to Report to CMS?

To earn recognition and points in this category, MIPS eligible clinicians must report MIPS Quality Measures for:

  • 2 high-weighted activities
  • 1 high-weighted activity & 2 medium-weighted activities
  • 4 medium-weighted activities

The only requirement is to perform improvement activities during 90 consecutive days.

How can Groups Submit IA Data?

Groups, virtual groups, and APM entities can attest to any activity if at least 50% of them perform the same activity. However, they don't need to indulge in activities at the same time.

How can Physicians Submit Data?

Depending on your MIPS data submission type, generally, clinicians can report in three ways.

·         Sign in and attest

·         Sign in and upload

·         Direct submission via API

Here is a table depicting which type qualified for which submission method.

Submitter Type

Sign in & Attest

Sign in & Upload

Direct Data Submission

MIPS Eligible Clinician

Yes

 

Yes

 

No

Group, Virtual Group, APM Entity

Yes

 

Yes

 

No

Third-Party Intermediaries

No

Yes

 

Yes

 


However, the best method is to consult a MIPS Qualified Registry and get free from the administrative load.

How CMS Score Your Performance?

CMS has the following criteria to gauge performance in the Improvement Activities (IA).

  • 20 points for High-weighted activities
  • 10 points for Medium-weighted activities

Benefits for Special Status in IA Reporting

If any individual clinician, virtual group, or group has a special status, they receive double points for high and medium-weighted activities.

What is in Store for APM Participants?

APM (Alternative Payment Model) clinicians participating in the QPP MIPS will receive 50% of the credit for their Improvement Activities.

How Patient-Centered Medical Homes Report for MIPS 2021?

The Patient-Centered Medical Homes or Specialty practice participants can earn maximum points in this category if they report timely. However, it is to note that healthcare organizations with multiple practice sites must have at least 50% recognized or certified locations for patient-centric medical homes.

What are the Reporting Criteria for QPP MIPS Data Attestation for Patient-Centered Medical Homes?

Patient-Centered Medical Homes can become eligible for reporting if they meet one of the following requirements.

  • Accreditation from a nationally accredited and well-reputed organization
  • Participant of Medicaid Medical Home Model or Medical Home Model
  • A comparable specialty practice with recognition through a specialty recognition program via a nationally recognized accreditation organization
  • Accreditation from a certifying body that certified a large number of medical organizations and complies with the national guidelines issued by the Secretary

Given below is the list of nationally recognized accreditation organizations.

  • The Joint Commission
  • The Compliance Team (TCT)
  • The National Committee for Quality Assurance (NCQA)
  • The Utilization Review Accreditation Commission (URAC)
  • The Accreditation Association for Ambulatory Health Care

Medical homes can get accreditation from these bodies, apply for QPP MIPS data submission 2021, and receive incentives and bonuses. 

Thursday 21 January 2021

Why Should Medical Practices Consider Group MIPS Participation?

MIPS eligible clinicians, MIPS reporting, healthcare services, Physicians, MIPS 2021 reporting, Medicare and Medicaid Services, medical practices, MIPS score, MIPS data reporting, MIPS Qualified Registry, report MIPS data, MIPS Group Reporting, MIPS data submission, MIPS data reporting, MIPS Quality Measures

When two or more MIPS eligible clinicians have the same TIN (Tax Identification Number) for billing, they can report as a group for MIPS reporting.

Advantages of MIPS Data Submission as a Group

MIPS (Merit-Based Incentive Payment System) is a way to receive incentives and bonuses for quality healthcare services to patients. Yes! Physicians can choose to report as individuals. However, there are more chances to succeed in MIPS 2020 reporting when you report as a group. Moreover, the administrative load is lesser and is shared among all parties.

CMS (Centers for Medicare & Medicaid Services) report says that with each passing year in MIPS 2021 reporting, more and more clinicians are interested in becoming a group.

How MIPS group reporting works? Is it feasible for MIPS-eligible clinicians? Is it beneficial for medical practices? Let’s have answers to these questions.

How Does MIPS Group Data Submission Work?

The primary criterion to form a MIPS group is to have two or more physicians in a medical practice under the same billing TIN.

Compound data was collected from all group participants, which CMS assesses on behalf of the group.

Each clinician will receive the same MIPS score at the end of the performance period. Moreover, everyone will receive the same payment adjustment. 

It is to remember that if you choose to report individually and in a group, CMS will evaluate your performance on both fronts. However, the payment adjustment will be awarded based on the high-scoring MIPS reporting method.

It Is Easier to Surpass the Performance Threshold with Group MIPS Reporting!

With each passing year, the performance threshold is also rising. Hence, MIPS reporting as a group makes it easy to target goals.

Group Reporting is Less Hectic!

For group MIPS data reporting, medical practices do not have to cater to the administrative load of everyone. Instead, they can hire a MIPS Qualified Registry to submit high-performing MIPS Quality Measures.

The paperwork is less, and you can manage data easily without stress.

Here is the overview of all the MIPS performance categories for groups.

 

Performance Category

Group Reporting Requirements

Quality

To report 6 Quality measures for the TIN

P.s: You do not have to choose quality measures that relate to all clinicians of the multi-specialty practice.

Performance Interoperability (PI)

Group attestation: Data aggregated in 2015 Edition CEHRT

The clinician not using the CEHRT still receives benefits of using one.

Improvement Activities (IA)

Group attestation: At least 50% of the clinicians have to perform the improvement activity at any given time of the year for continuous 90 days.

Cost

CMS measures performance by itself.

Improved Performance in QPP MIPS Group Reporting

MIPS reporting in a group is particularly useful when any clinician fails to meet the performance threshold.

Financial Benefits for MIPS Group Reporting

When you report as a group, the payment incentives spread across the whole group. Even if any clinician had failed to target incentives while reporting individually, they would still qualify for the payment adjustment.

CMS estimates that clinicians can receive a maximum bonus of up to 6.25% if they receive a 100% score. Thus, a medical practice can stay ahead in financial matters if they choose to report MIPS data in a group.

Conclusion

There are numerous advantages of MIPS reporting as a group if many physicians bill under the same TIN. The bottom line is medical practices can save time and effort from investing in the administrative burden from group data submission. We suggest consulting a MIPS Qualified Registry for the quality and timely MIPS data submission to CMS.


Wednesday 6 January 2021

New Drug Prescription Cost Rule Allows Negotiation against Patient Outcomes

CMS promised to address rising healthcare expenses, administrative burden, and the lack of quality systems, and they are gradually settling every concern that is restricting progression. In the same context, recently, we heard the great news, especially for medical billing and QPP MIPS reporting.

CMS has decided to base prescription drug payments on the patients’ outcomes. They proposed a rule on June 17 to counter rising drug prescription prices.

What Statistics Say About Drug Prescription Spending?

Statistics reflect that the average growth spending of 5.7 percent on national health is expected between 2020 to 2027. However, the new rule will help establish a system with lesser regulations on Value-Based Purchasing (VBP). 

How CMS defines VBP?

The proposed rule will allow commercial payers to negotiate with manufacturers under new rules. However, the deal is that Medicaid beneficiaries always get the best price. The new rule will also ensure to pay the price that aligns with both objectives:

  • New types of payment models
  • Situations under which prices are negotiated

This value-based purchasing rule intends to accommodate new changes in the healthcare industry while giving details to stakeholders.

In actual terms, CMS defines it as and I quote:

“An arrangement or agreement intended to align pricing and/or payments to an observed or expected therapeutic or clinical value in a population (that is, outcomes relative to costs) and includes (but is not limited to):

  • Evidence-based measures: linking drug expense of a drug to the effectiveness of the product, and/or
  • Outcomes-based measures: linking expense of a drug to the product's actual performance in a patient or a population as compared to the other medical expenses.”

It will offer flexibility to medical billing services, Medicaid, insurance companies, and drug manufacturers.

Current Drug Regulation Rules Lack Flexibility

Seema Verma, the CMS administrator, states that the rules for Medicaid receiving the competitive price for drug prescription have not been updated in nearly thirty years. 

With no new rules to accommodate the changing environment, healthcare leaders lack the opportunity to design new payment models for physicians.

How the New Drug Prescription Rule Facilitates Physicians?

As the new proposed rules will come into action, drug manufacturers will have more say in the payment arrangements. In addition, the patients' outcomes will make clinicians accountable for their services, and they can invest in opportunities to earn more revenue, particularly via QPP MIPS.

Right now, the payment arrangements are made on the quantity of the product rather than the quality of the product. 

In such circumstances, it is impossible to move towards innovation; consequently, medical billing companies can't drive value to the claims nor can payers promote access to innovative therapies or drugs due to cost prohibitions.

The Effect on Healthcare Industry

The new proposed rule is, however, like a breath of fresh air that will support all private and governmental healthcare stakeholders based on clinical outcomes. Providers can prescribe new medicines for better results, enhancing their QPP MIPS reporting performance.

The connection between the payment and the quality of drugs will eventually create paths for innovative medical treatments, and the effectiveness of medication and therapies is likely to increase - An effective way to promote MIPS quality measures.

The Effect on Opioid Crisis 

The high consumption of opioids has led to a crisis in the country. The acting secretary of Health and Human Services (HHS) says that around seventy percent of drug overdoses are related to opioids. Thus, the misuse of this drug has been alarming.

CMS counters this situation via the proposed rule, as there would be a safe passage for drug prescription, which will eventually reduce misuse or abuse of opioids.

The Future of Drug Prescription

Luckily, CMS has settled concerns that were raised by medical billing services. Moreover, the proposed drug prescription rule caters to everyone for easy access to quality healthcare, promoting QPP MIPS while reducing expenses.

We hope that this rule when implemented properly fixes many payment-related issues and reimburse physicians via value-driven methods.

Thursday 31 December 2020

HHS Released Guidelines on HIPAA Compliance amidst Pandemic

Medical billing services, healthcare professionals, and other stakeholders are bound by HIPAA Law or “HITECH Law of 2009” to protect and restrain the misuse of sensitive healthcare information. 

When we join a medical billing company, the first thing that medical billers, coders, auditors, and physicians learn is to safeguard the Protected Health Information (PHI). Moreover, there are proper guidelines to avoid the misinterpretation of the confidentiality of patients' data.

Medical Practices are Sharing Data with Authorities for Research 

Healthcare IT experts have decided that we can find ways to restrict virus exposure and even prevent another health emergency to happen with proper data analysis. Thus, at these drastic times, medical practices are asked to share data for research purposes. In such situations, as a HIPAA-compliant medical facility, how would you respond to such requests? Will there be any prerequisites for sharing data? What information are healthcare professionals and outsourcing medical billing companies are allowed to share? Moreover, it will also affect QPP MIPS reporting requirements. 

There are lots of questions that we have to answer.

The U.S Department of Health and Human Services (HHS) has answered all these questions without ambiguity. Let's follow through.

Changes in HIPAA Policies during COVID-19

In February 2020, the Office of Civil Rights released a bulletin for covered entities and business associates about the epistemology of sharing patient data amidst the pandemic.

They say:

Healthcare entities can release the patient’s data without the patient's authorization if it’s important to treat another life or that patient in general. Treatment here refers to the management or coordination among healthcare entities, such as one or more healthcare professionals, medical billing services, care of providers, and the referrals of patients.

Another thing that we all have to keep in mind is this relaxation is only in effect during the COVID-19 pandemic (Public Health Emergency (PHE) and is likely to revert or annul or update when the situation gets back to normal.

The Situations where we can Share Information without Patient’s Authorization

Under privacy rules, healthcare service providers can share PHI in specific cases without prior authorization.

So, what are those cases?

Only the Public Health Authority, for instance, the CDC or a state or local health department can receive or share data to prevent any public health emergency, disability, or disease. It includes all reportable cases such as disease, injury, births, deaths, and surveys for public health surveillance, investigations, or interventions.

Explicitly speaking, a covered entity may disclose PHI to the CDC regularly as needed to report cases (prior and prospective) of patients exposed, suspected, or confirmed to have Novel Coronavirus.

Severe Cases When Health Providers Can Share PHI 

Moreover, there are other severe cases where clinicians are allowed to share information such as,

  • When the patient is unconscious, but it is in the best interests of the patient
  • When disaster relief organizations (For Example, Red Cross) are unable to operate fairly in an emergency 
  • When there is a person or public in general with a critical health condition to prevent them from a fatal condition

Having stated these non-consensual cases, it is the best practice for healthcare organizations or medical billing companies to ask for permission from patients. However, unfortunately, it is not the case in most cases because the patients might not be in a condition to allow anything.

Be Careful About What You Share 

Clinicians must avoid releasing information about specific tests, test results, or details of a specific illness or treatment without proper consent from the patient or the representative party!

QPP MIPS reporting neither criteria nor do HIPAA compliance rules allow it. 

How is the Pandemic Holding Up with the HIPAA Compliance?

The relaxations in the privacy policies are in favor of a progressive and active healthcare system. However, some conditions are not changed, such as the Minimum Necessary constraint, unless another healthcare professional requires the information.

This stance is explained in the press release as:

A covered entity depends on the CDC that the protected health information (PHI) requested by the CDC about all patients exposed or suspected or confirmed to have coronavirus is the minimum necessary case for the public health purpose. Furthermore, patients can restrict access to their information for the workforce members who need it to perform several tasks or research.

Conclusion

The relaxations subjected to the privacy rules of HIPAA compliance don’t imply any loose ends for security measures. The parties associated with the information, such as covered entities, billing services, MIPS Qualified Registries, and clinicians, must adopt all means to protect information from falling into the wrong hands.

The authorities presented several press releases as the pandemic progressed. One of them was released on April 2, 2020, saying that:

Starting instantly, there would be no penalties for exposing information under the HIPAA Privacy Rules for goodwill purposes for all business associates during the pandemic.

Hopefully, it helps scientists to highlight meaningful aspects of a progressive healthcare system. Moreover, it allows physicians long-term relaxation without compromising patients' privacy and quality healthcare for QPP MIPS reporting.

 

Unveiling the Importance of QPP MIPS Qualified Registry Reporting in 2023

As we usher in the new year, healthcare providers in the USA are gearing up for another round of the Merit-Based Incentive Payment System (M...