CMS Weekly Webinar Notes February 7, 2018

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1 CMS Weekly Webinar Notes February 7, 2018 CAVEAT I m not a medical professional and have not read all of the measure documentation. Please ask for clarification if you find the information below to be questionable. Thanks. James Malayang 2/7/2018 Q&A SESSION 1. Do you need to wait 30 days to bill TCM or or can you bill at time of visit? Hi Alison, For questions related to billing, please contact your Medicare Administrative Contractor (MAC). 2. For Tobacco Screening and Cessation if it is noted that a patient is a non-smoker or former smoker will this satisfy for the measure or do they need to be asked about smokeless tobacco as well? Hi Kayleigh. The intent of the measure is to assess for smoking and smokless tobacco use and provide intervention of necessary. They will need to be assessed for smokeless tobacco use as well to meet this measure 3. regarding PREV-13, will hyperlipidemia (dx E78.5) suffice to satisfy the required dx of Hypercholsterolemia? Hi Ingrid. Per the measure developer hyperlipidemia is not included as a diagnosis to confirm denominator eligibility for Risk Category 2 in the 2017 PREV-13 measure. 4. Also, where can Track 1 MSSP ACOs attest the ACI Measures? We're only seeing teh CMS Web Interface Measures on the QPP. ACO participant TINs must report ACI and can do so through the QPP website. There are ACI resources in the 2017 QPP Resource Library and a helpful youtube video describing how ACO participants can report ACI: 5. When do you expect the diabetic measures in the Web interface to be corrected? The data entered is not being reflected. There are currently no known issues with the data being recorded in the measures. We did have an issue specific to Internet Explorer that was corrected. Please enter a helpdesk ticket with the specifics of your issue so that we can investigate what is happening in your submission 6. Medical record states "Tobacco Screening: Never a smoker" is this sufficient for screening for Prev 10 since it's labeled Tobacco Screening? Hi Stephanie. No, there needs to be documentation stating that smokeless tobacco use was assessed as well to meet the intent of the measure. 7. Medical record states "Tobacco Screening: Never a smoker" is this sufficient for screening for Prev 10 since it's labeled Tobacco Screening? No, there needs to be documentation stating that smokeless tobacco use was assessed as well to meet the intent of the measure.

2 8. In our patient list, we found 16 patients who match on almost all of the demographics, but there are small things that don't match...name misspelled, brithdate wrong, etc... What should we do about these patients? It sounds like you are able to match these patients on their Medicare IDs/HICNs. Is that correct? If so, please correct their dates of birth as needed (and names to the extent you would find that helpful during data collection) and continue reporting on them. 9. when will you post the slides for all the web interface calls? I have asked on each call and receieve a response however the slides are not located on this link. Please review question and respond approriately. thanksthe materials for the webinars through 1/24 have been posted here: Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/Quality-Payment-Program- Events.html. 10. How do I fix an error that is showing up in the error report in the WI that says "invalid enum entry" for column A. This is the medicare number and I have confirmed that it is the same in my excel sheet and the WI. Thanks. The invalid enum entry error is associated with selecting an incorrect choice when there is drop down list of choices in the Column, The choices are determined by the header in the column. The choices must match exactly. 11. I need clarification regarding HMO Enrollment. Per The 2017 CMS Web Interface Submission Guidance HMO Enrollment is explained- Select this option if the patient was enrolled in an HMO at any time during the measurement period (i.e., Medicare Advantage, non-medicare HMOs, etc.). During the 1/24/18 Q&A the following question was asked:if Patient has HMO but is secondary to Medicare, this patient counts for the measures correct? It is only if the HMO is primary that they are excluded. This was answered as YES. Can you clarify as the web interface measure specs do not state this. Yes, it is correct that the HMO Enrollment exclusion is only appropriate for cases where the patient had something other than Medicare FFS as their primary payer at some point in This additional information can be found in the "Skipping Beneficiaries" area of the FAQs within the CMS Web Interface 12. What constitutes "successful reporting" for our first reporting year? Submitting the minimum required data for all 14 measures constitutes successful reporting for the CMS Web Interface. 13. What happens if we do not get a CMS approved reason and end up reporting on patients who should have been excluded since they are in the CEC ESRD program? Will they get skipped automatically by CMS or will the data be counter in measure performance rates?they will not be automatically excluded, so it is important that you submit a request for a CMS approved reason to skip. 14. For the HMO enrolled that disqualifies them from a measure. If Medicare is secondary and a commercial plan is primary, is that considered HMO enrolled? Yes, the key is that a commercial plan is primary payer. Because that is the case, it would be appropriate to select HMO Enrollment here. 15. Flue shot: can the office visit be specialist or PCP. Either. If the visit was somewhere else but get through claims, can they be counted? Yes. If the flu shot is prepopulated, don't substantiate. If you are providing, then do substantiate. 16. Is dementia a valid med reason for not doing depression screening? If you have documention must indicate that the reason they weren't scenes was because of dementia, Select No. CMS Weekly Webinar Notes: 2/7/ P age

3 FREQUENT MEASURE QUESTIONS These were shared via slides and rather than transcribe them, they are pictured below. CMS Weekly Webinar Notes: 2/7/ P age

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