Latest News

As a reminder, the Provider Relief Fund (PRF) Reporting Portal is open for recipients to report on funds (exceeding $10,000 in aggregate) received from April 10, 2020 to June 30, 2020. Providers who received one or more payments exceeding $10,000 in the aggregate during one of the four Payment Received Periods are required to report in each applicable reporting period. Following #MGMAAdvocacy efforts, providers now have 90 days, instead of 30, to report their use of funds. For more information, see MGMA’s updated PRF resource.

This afternoon, the Department of Health and Human Services (HHS) released its first regulation implementing provisions of the No Surprises Act. On Dec. 27, 2020, the No Surprises Act was signed into law as part of the Consolidated Appropriations Act of 2021, with the goal of protecting patients from receiving surprise medical bills. The law, in part, allows providers and insurers to use an independent dispute resolution (IDR) process when disagreements arise over reimbursement. MGMA was successful in advocating that Congress forbid arbitrators from considering public payer reimbursement rates during the IDR process. The law goes into effect on Jan. 1, 2022.

For more information, review HHS’ fact sheet and the interim final rule. MGMA will release a comprehensive analysis of the rule to members in the coming weeks.

Earlier this week, MGMA sent a letter to the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) asking it to rescind or delay its emergency temporary standard (ETS) aimed at protecting workers facing the highest coronavirus hazards — those working in healthcare settings where suspected or confirmed coronavirus patients are treated. MGMA believes the ETS was issued much too late and will disrupt the ongoing efforts of medical groups to balance the needs of patients against the imperative to protect employees. MGMA hopes that OSHA will rescind the ETS, or at a minimum, delay its effective date until stakeholders have adequate opportunity to provide input on the standard.

The Centers for Medicare & Medicaid Services (CMS) announced that 2021 alternative payment model (APM) incentive payment details are now available on the QPP website. After logging in, organizations will be able to see the amount paid for eligible clinicians that achieved qualifying participant (QP) status during the 2019 performance year. Clinicians who were QPs in an advanced APM entity in 2019 should begin receiving a 5% APM incentive payment this month.

No action is required to receive these payments unless CMS is unable to verify a clinician's Medicare billing information. If payment is not received, check the CMS public notice, which indicates the names of clinicians whose billing information could not be verified. Such clinicians will need to verify their Medicare billing information by November 1, 2021, in order to receive their APM incentive payment. For additional information, download CMS' 2021 Learning Resources for QP Status and APM Incentive Payment zip file.

While COVID-19 cases have slowed considerably in Tennessee, the work is far from over. With fewer than 50% of Tennesseans having received at least one dose of a COVID-19 vaccine, the unknown impact of the upcoming fall respiratory season, increasing variant strains, and booster vaccines likely on the horizon, the TN Department of Health is asking Tennessee’s health care providers to assist with vaccinating Tennesseans at every opportunity. If your practice is already administering COVID-19 vaccines, thank you! If your practice is not, please consider signing up to do so! Our team will walk you through the process. Patients trust you, and your strong recommendation to get vaccinated is critical to protecting Tennesseans from the next surge.  Please visit COVID-19 Vaccine Information for Healthcare Providers (tn.gov) For more information on becoming a pandemic vaccine provider, or email vaccine.onboarding@tn.gov to get started in the process.  Please help us protect the people of Tennessee!

MGMA joined 12 leading healthcare organizations in supporting the Accountable Care in Rural America Act, a recently reintroduced bill that addresses the way financial targets are set for Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program. This piece of legislation would improve the accuracy and fairness in evaluating ACOs by fixing the "rural glitch," a flaw in the benchmarking methodology that disproportionately affects rural ACOs. We hope Congress acts to correct this flaw and levels the playing field for all ACOs to achieve savings when they improve quality and reduce costs.

The Centers for Medicare & Medicaid Services (CMS) has notified MGMA that it plans to start distributing 2019 performance year advanced alternative payment model (APM) incentive payments beginning Thursday, June 24. Group practices that participated in an advanced APM in 2019 and whose clinicians achieved qualifying participant (QP) status by meeting patient or payment thresholds in 2019 should begin receiving these 5% bonus payments in the coming days. CMS plans to publish a notice for any providers that expect to receive these payments but do not, so that they can provide the agency with the appropriate information to receive their payment. 

This morning, the U.S. Supreme Court dismissed a challenge to the Affordable Care Act (ACA), leaving the law intact. In the 7-2 decision, the justices said the challengers of the law lacked standing to bring the case. The case, California v. Texas, centered around the ACA’s individual mandate, which required individuals to obtain minimum health insurance coverage or face a tax penalty. Once the tax penalty was set to $0 in a subsequent tax law, the plaintiffs argued that without the tax consequences associated with the individual mandate, the individual mandate was unconstitutional and the rest of the ACA must be found unconstitutional as well. The Court threw out this challenge to the law today due to lack of legal standing because the plaintiffs could not show injury.

HHS releases updated PRF reporting guidance, establishes new deadlines

The Department of Health & Human Services (HHS) released long-awaited updates to reporting guidance for the Provider Relief Fund (PRF). According to the press release and the newly updated Post-Payment Notice of Reporting Requirements document, only relief funds received prior to June 30, 2020, must be expended by June 30, 2021, a deadline that the Department established previously. HHS designated four different reporting periods and deadlines to use funds based on the dates relief funds were initially received. HHS also heeded MGMA's recommendation to extend the 30-day reporting period to a full 90 days following the spending deadline for each period. Finally, the announcement indicates that the PRF Reporting Portal will allow providers to begin reporting their use of funds on July 1, 2021. Providers that received one or more payments exceeding $10,000 in the aggregate during a single Payment Received Period will be required to report. Additional resources, including a reporting toolkit, will become available upon the opening of the Reporting Portal. 

OSHA announces new COVID-19 temporary standard for healthcare settings

The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) issued a COVID-19 emergency temporary standard (ETS) and accompanying FAQ with implications for healthcare employers. In part, under the ETS, a covered employer must:

•  Develop a “COVID-19 plan,” which includes a workplace-specific hazard assessment,
•  Clean and disinfect the workplace,
•  Screen employees for COVID-19 and follow requirements for removing employees from the workplace,
•  Ensure physical distancing,
•  Screen and monitor patients upon arrival,
•  Report COVID-19 fatalities and hospitalizations, and
•  Provide reasonable time and paid leave for COVID-19 vaccinations.

HHS Secretary Becerra addresses PRF, guidance forthcoming

During a House Ways and Means Committee hearing on the Department of Health and Human Services' (HHS) budget request, Secretary Xavier Becerra addressed the Provider Relief Fund (PRF) and told lawmakers that the Department would be releasing additional guidance this month. Physician practices still only have until June 30 to use any PRF money received. Last month, MGMA sent a letter to HHS recommending modifications to the PRF program, including an extension of the spending deadline and the expeditious distribution of the remaining relief funds to medical group practices and other providers.

MSSP 2022 application period now open