MGMA Washington Connection 09/23/21

09/23/2021 10:14 AM | Anonymous

New Provider Relief funding available next week

The U.S. Department of Health and Human Services (HHS) plans to open applications for a new round of Provider Relief Fund payments totaling $25.5 billion in distributions beginning Sept. 29, 2021. This new funding includes $8.5 billion for providers furnishing services to Medicaid, Children's Health Insurance Program (CHIP), or Medicare patients in defined rural areas, and an additional $17 billion for a Phase 4 General Distribution for providers who can document lost revenue and changes in operating expenses between July 1, 2020, and March 31, 2021. Consideration for both distributions will be determined through a single application on the Health Resources & Services Administration (HRSA) website, and HRSA will use Medicaid, CHIP, and Medicare claims data in the calculation of payments.

As a reminder, HHS is allowing a 60-day grace period following the upcoming Sept. 30 reporting deadline for providers that received greater than $10,000 in Provider Relief funds between April 10 and June 30, 2020. HHS indicated it will not initiate any recoupment or enforcement actions for 60 days following the deadline, allowing for a period of enforcement discretion from Oct. 1 – Nov. 30, 2021. For additional information on the Provider Relief Fund, reference MGMA’s recently updated resource detailing program updates, requirements, and deadlines.

MIPS automatic neutral payment adjustment applies to clinicians impacted by Hurricane Ida

The Centers for Medicare & Medicaid Services announced that certain clinicians participating in the Merit-based Incentive Payment System (MIPS) will automatically receive a neutral payment adjustment for the 2021 performance year/2023 payment year due to the impact of Hurricane Ida. Clinicians located in declared disaster areas, including Louisiana, Mississippi, New York, New Jersey, and Missouri, will automatically have their performance scores across all four MIPS categories reweighted to 0% and receive a neutral payment adjustment in 2023.

However, impacted clinicians can still choose to submit MIPS performance data. If data is submitted for at least two performance categories, the clinician will be scored and have payment adjustments applied in 2023. While the automatic reweighting policy does not apply to groups or virtual groups, these MIPS participants can apply for reweighting of one or more MIPS performance categories.


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