CMS lays out regulatory relief for value-based care programs amid COVID-19 pandemic

The Trump administration has extended the deadlines for quality reporting and applications for providers in value-based care programs.

The Centers for Medicare & Medicaid Services (CMS) released Sunday relief for regulatory requirements as providers face the growing tide of COVID-19 patients.

CMS also announced it will not use any quality data on services from Jan. 1 through June 30 in the agency’s calculations for quality reporting and value-based purchasing programs.

“This is being done to reduce the data collection and reporting burden on providers responding to the COVID-19 pandemic,” CMS said in a release Sunday. “CMS recognizes that quality measure data collection and reporting for services furnished during this time period may not be reflective of their true level of performance on measures such as cost, readmissions and patient experience during this time of emergency.”

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Provider groups had asked for CMS to waive any performance results or quality scores for the entirety of 2020.

CMS extended the deadline for the Merit-based Incentive Payment System (MIPS) and accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) to submit 2019 data. The original deadline was March 31, but they now have until April 30 to submit quality data from 2019.

However, CMS said it is still evaluating its options for “providing relief around participation and data submission for 2020” for the MIPS and MSSP programs.

CMS did say that MIPS-eligible physicians who haven’t submitted any data for the program by April 30 will still qualify for relief and get a “neutral payment adjustment for the 2021 MIPS payment year.”

But hospitals won't need to submit data from Jan. 1 till June 30 for programs targeting kidney disease and hospital-acquired conditions.

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The same extension goes for post-acute care programs such as the hospice and home health quality reporting programs and the long-term hospital quality program. But missing from the guidance is any mention of the application deadline for the direct contracting program for ACOs.

The application for the implementation year was last month, and the application deadline for the 2021 performance year is expected this spring. CMS did not mention whether it will be pushing back the start of the program.

Some provider groups were happy with the announcement. 

"CMS’ decision to offer relief from the reporting demands in the Quality Payment Program will be felt immediately," said Patrice Harris, M.D., president of the American Medical Association, in a statement. "Doctors don’t have much time to breathe a sigh of relief, but if they did, they would take a moment to thank CMS for this wise decision."