HHS SCAM ALERT: INDIVIDUAL POSING AS OCR INVESTIGATOR
HHS Scam Alert: Individual Posing as OCR Investigator
It has come to OCR’s attention that an individual posing as an OCR Investigator has contacted HIPAA covered entities in an attempt to obtain protected health information (PHI). The individual identifies themselves on the telephone as an OCR investigator, but does not provide an OCR complaint transaction number or any other verifiable information relating to an OCR investigation.
HIPAA covered entities and business associates should alert their workforce members, and can take action to verify that someone is an OCR investigator by asking for the investigator’s email address, which will end in @hhs.gov, and asking for a confirming email from the OCR investigator’s hhs.gov email address. If organizations have additional questions or concerns, please send an email to: OCRMail@hhs.gov.
Suspected incidents of individuals posing as federal law enforcement should be reported to the Federal Bureau of Investigation (FBI). The FBI issued a public service announcement about COVID-19 fraud schemes HERE. The FBI has seen a rise in COVID-19 related scams.
Contact us at Kentucky REC with your questions. We’re here to help and are available at 859-323-3090.
NCQA UPDATES FOR PCMH/PCSP DURING THE COVID-19 NATIONAL EMERGENCY
On Tuesday, March 24, 2020, the National Committee for Quality Assurance (NCQA) enacted policies for NCQA staff, contractors, and events, based on updates from the CDC and other authorities. Please find information regarding changes affecting PCMH/PCSP Recognition programs as a response to the Coronavirus national emergency below:
NCQA:
- Is prepared to conduct all business activities virtually if needed
- Will continue to deliver all systems, surveys, support services, contract, and grant related services
- Is assessing large meetings, events, and conferences with the goal to convert to virtual events
EXCEPTIONS:
Practitioners Who Provide Care During a Public Health Emergency
- Organizations don’t need to credential practitioners who are not part of their network or practice and are providing care to members/patients as part of a federal, state, or local government emergency response team.
- Organizations don’t need to credential practitioners part of the organizations emergency response efforts if it documents disaster management plans implemented from March – September for allowing these practitioners to provide care for members.
CMS 1135 Waivers for State Licensing
- CMS allows states to request a waiver that temporarily allows out of state practitioners to provide services licensed in another state. When credentialing practitioners in a state that receive a waiver, NCQA will waive the requirement that organizations verify the license to practice for that state.
Health Care Organizations & Practices Whose Operations are Affected
- NCQA will be flexible in scoring organization performance during the March – September time frame. Organizations will need to provide documentation regarding the circumstances that interfered with meeting requirements.
- Practices may show evidence from any time in the past year, so organizations may demonstrate activities were implemented before and after the March – September time frame.
SURVEY ACCOMODATION INFORMATION:
- Organizations with an upcoming survey or evaluation in 2020 should contact their Recognition account representative. NCQA will determine if additional accommodations (e.g., longer extensions, virtual surveys, shorter look-back periods) are necessary on a case-by-case basis.
NCQA will continue to assess the situation and will make updates as needed. For further information and updates: NCQA COVID-19
HERE is a one pager with this NCQA information for your reference.
Contact us at Kentucky REC with your questions. We’re here to help and are available at 859-323-3090.
QPP YEAR 4 WEBINAR APRIL 30: MIPS ALTERNATIVE PAYMENT MODELS
One of the goals of the Quality Payment Program is for providers to move into what are called Advanced Alternative Payment Models. In Year 4 of the QPP, clinicians who meet the billing and/or patient thresholds in an Advanced APM are still eligible for the 5% lump sum payment. Over the course of this program, the requirements and flexibilities afforded to APM participants have evolved. Initially almost all participants in Advanced APM models met the billing and/or patient thresholds, making them eligible for the Qualified Participant status. However, as the thresholds (and the difficulty of meeting them) have increased, the likelihood of becoming a Qualified Participant or Partial QP status has declined. Because of this, many clinicians may find themselves evaluated on the MIPS APM scoring standard.
During our webinar, our quality experts will discuss the changes to the APM track and how the increases to the billing and/or patient thresholds may impact your requirements and performance in the QPP.
*Webinar – QPP Year 4: MIPS Alternative Payment Models
Thursday, April 30, 2020 12:30 PM ET
Coming Up:
*May 21 – QPP Categories Year 4: Cost
June 18 – QPP Year 4: Kentucky REC Can Help You Improve Your QPP Performance
*July 16 – QPP Categories Year 4: Promoting Interoperability & Improvement Activities
All QPP Webinars start at 12:30 PM ET
*This webinar is for Kentucky REC contracted QPP clients only. If you are interested in this topic and would like to learn more about becoming a client, please contact us at (859) 323-3090 or Kentucky REC. We aim to be your trusted healthcare advisor!
Future dates subject to change
KENTUCKY MEDICAID EHR INCENTIVE PROGRAM (PROMOTING INTEROPERABILITY) – DEADLINE EXTENDED!
Due to the COVID-19 novel coronavirus national emergency, the Kentucky Medicaid EHR Incentive Promoting Interoperability Program (Meaningful Use Stage 3) has changed the reporting deadline from 3/31/2020 to 4/30/2020 for all Eligible Providers (EPs).
From the Kentucky Cabinet for Health and Family Services page:
“Program Year 2019 Attestations – Deadline Extended to April 30, 2020
The Kentucky Medicaid EHR Incentive Program (Promoting Interoperability) is accepting the program year 2019 attestations until 11:59 p.m. April 30, 2020. Any attestation not submitted will be closed out and ineligible for participation for the program year. To assist with your attestation, please see the EP User Manual on the EHR website. For questions or concerns, please contact the EHR team by email or calling (502) 564-0105, ext. 2463.”
Here is the link to the statement .
Contact your Kentucky REC advisor with any questions. If you don’t have a Kentucky REC advisor, contact us at Kentucky REC with your questions. We’re here to help and are available at 859-323-3090.
CMS ANNOUNCES RELIEF FOR CLINICIANS, PROVIDERS, HOSPITALS, AND FACILITIES PARTICIPATING IN QUALITY REPORTING PROGRAMS IN RESPONSE TO COVID-19
UPDATED APRIL 3, 2020
On Sunday March 22, 2020, Centers for Medicare and Medicaid (CMS) announced relief for Clinicians, Providers, Hospitals and Facilities participating in Quality Reporting Programs as a response to COVID-19.
These relief efforts include the extension of the deadline for the Quality Payment Program reporting from March 31, 2020, to April 30, 2020. In addition to the extension of the deadline for the quality reporting program (includes MIPS & APM tracks), CMS also extended the criteria and approach for hardships. MIPS eligible clinicians who have not submitted any MIPS data by April 30, 2020, will automatically qualify for the extreme and uncontrollable circumstances policy and will receive a neutral payment adjustment for the 2021 MIPS payment year. CMS further clarified that any MIPS EC who submits two or more performance categories will be evaluated as normal under the program.
THE GOOD NEWS: this change provides those participating in the Quality Payment Program extensive flexibility. Should you have any questions around how this can impact your practice, please contact your Kentucky REC advisor or call us at 859-323-3090.
Please see below for an overview of the changes for the Quality Payment Program:
| Provider Programs | 2019 Data Submission | 2020 Data Submission |
|---|---|---|
| Quality Payment Program - Merit-based Incentive Payment System (MIPS) | Deadline extended from March 31, 2020 to April 30, 2020. MIPS eligible clinicians who have not submitted any MIPS data by April 30, 2020 will qualify for the automatic extreme and uncontrollable circumstances policy and will receive a neutral payment adjustment for the 2021 MIPS payment year. | CMS is evaluating options for providing relief around participation and data submission for 2020. |
| Medicare Shared Savings Program Accountable Care Organizations (ACOs) |
The 2019 MIPS Extreme and Uncontrollable Circumstances Policy Update is for MIPS Eligible Clinicians who HAVE NOT SUBMITTED any data for the 2019 MIPS program. No additional action is necessary to qualify for this policy. Clinicians will be automatically identified, and those meeting this policy will receive a neutral MIPS payment adjustment during the 2021 MIPS payment year. CMS has updated the QPP Participation Status Tool so Eligible Clinicians can see if the policy has been automatically updated.
For MIPS Eligible Clinicians and/or Groups who have started, but have not been able to complete their submission, and Virtual Groups that are unable to start or complete their submission, then an APPLICATION for the MIPS Extreme and Uncontrollable Circumstances must be submitted by April 30, 2020.
PLEASE NOTE: If data is submitted for two or more of the MIPS performance categories, then CMS will score and clinicians and/or groups will receive a payment adjustment based on the submitted data for the 2019 performance year.
For further information on Hospital and Post-Acute Care (PAC) programs, CLICK HERE for the recent Press Release about the CMS Quality Payment Program.
For further information on the Reporting Relief, refer to the CMS QPP COVID-19 Response Fact Sheet.
HERE is a Fact Sheet with this CMS QPP information for your reference.
Contact us at Kentucky REC with your questions. We’re here to help and are available at 859-323-3090.
MEDICARE TELEHEALTH COVERAGE DURING THE COVID-19 NATIONAL EMERGENCY
Under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act, CMS has expanded access to Medicare telehealth services for beneficiaries. This response is in an effort to ensure that all beneficiaries, particularly those at high-risk of complications, can maintain access to the care they need.
Our expert advisors have created a Fact Sheet to guide you through these changes during the national emergency due to COVID-19.
You can access the Fact Sheet HERE.
Contact us at Kentucky REC with your questions. We’re here to help and are available at 859-323-3090.
COVID-19 AND THE HIPAA PRIVACY RULE
COVID-19 and The HIPAA Privacy Rule: Bulletins from HHS
In light of the COVID-19 national emergency, the Health and Human Services (HHS) Office for Civil Rights (OCR) has released information specific to the HIPAA Privacy Rule. The Kentucky REC wants to make sure you are aware of the information coming from HHS in order for you to be able to continue providing healthcare services to patients. Below is a collection of all bulletins released from HHS regarding modifications and waivers related to the HIPAA Privacy Rule.
The Kentucky REC will continue to share updates and releases with hyperlinks from HHS as the information becomes available. Each of the titles below is hyperlinked to the information described.
March 24, 2020: COVID-19 and HIPAA: Disclosures to Law Enforcement, Paramedics, Other First Responders and Public Health Authorities
Today, the Office for Civil Rights (OCR) at the U.S Department of Health and Human Services (HHS) issued guidance on how covered entities may disclose protected health information (PHI) about an individual who has been infected with or exposed to COVID-19 to law enforcement, paramedics, other first responders, and public health authorities in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule.
The guidance explains the circumstances under which a covered entity may disclose PHI such as the name or other identifying information about individuals, without their HIPAA authorization, and provides examples including:
• When needed to provide treatment;
• When required by law;
• When first responders may be at risk for an infection; and
• When disclosure is necessary to prevent or lessen a serious and imminent threat.
This guidance clarifies the regulatory permissions that covered entities may use to disclose PHI to first responders and others so they can take extra precautions or use personal protective equipment. The guidance also includes a reminder that generally, covered entities must make reasonable efforts to limit the PHI used or disclosed to that which is the “minimum necessary” to accomplish the purpose for the disclosure.
“Our nation needs our first responders like never before and we must do all we can to assure their safety while they assure the safety of others,” said Roger Severino, OCR Director. “This guidance helps ensure first responders will have greater access to real time infection information to help keep them and the public safe,” added Severino.
March 20, 2020: FAQs on Telehealth and HIPAA During the COVID-19 Nationwide Public Health Emergency
The Office for Civil Rights (OCR) at the U.S Department of Health and Human Services (HHS) issued guidance on telehealth remote communications following its Notification of Enforcement Discretion during the COVID-19 nationwide public health emergency.
The Notification, issued earlier this week, announced, effective immediately, that OCR is exercising its enforcement discretion to not impose penalties for HIPAA violations against healthcare providers in connection with their good faith provision of telehealth using communication technologies during the COVID-19 nationwide public health emergency.
The new guidance is in the form of frequently asked questions (FAQs) and clarifies how OCR is applying the Notification to support the good faith provision of telehealth.
March 17, 2020: Notice of Enforcement Discretion for Telehealth
The HHS Office for Civil Rights (OCR) announced on March 17, 2020, that it will waive potential HIPAA penalties for good faith use of telehealth during the nationwide public health emergency due to COVID-19.
A covered health care provider that wants to use audio or video communication technology to provide telehealth to patients during the COVID-19 nationwide public health emergency can use any non-public facing remote communication product that is available to communicate with patients. OCR is exercising its enforcement discretion to not impose penalties for noncompliance with the HIPAA Rules in connection with the good faith provision of telehealth using such non-public facing audio or video communication products during the COVID-19 nationwide public health emergency. This exercise of discretion applies to telehealth provided for any reason, regardless of whether the telehealth service is related to the diagnosis and treatment of health conditions related to COVID-19.
The notification explains how covered health care providers can use everyday communications technologies to offer telehealth to patients responsibly.
March 16, 2020: Limited Waiver of HIPAA Sanctions and Penalties During a Nationwide Public Health Emergency
In response to President Donald J. Trump’s declaration of a nationwide emergency concerning COVID-19, and Secretary of the U.S. Department of Health and Human Services (HHS) Alex M. Azar’s earlier declaration of a public health emergency on January 31, 2020, Secretary Azar has exercised the authority to waive sanctions and penalties against a covered hospital that does not comply with the following provisions of the HIPAA Privacy Rule:
• the requirements to obtain a patient’s agreement to speak with family members or friends involved in the patient’s care. See 45 CFR 164.510(b).
• the requirement to honor a request to opt out of the facility directory. See 45 CFR 164.510(a).
• the requirement to distribute a notice of privacy practices. See 45 CFR 164.520.
• the patient’s right to request privacy restrictions. See 45 CFR 164.522(a).
• the patient’s right to request confidential communications. See 45 CFR 164.522(b).
The waiver became effective on March 15, 2020. When the Secretary issues such a waiver, it only applies:
(1) in the emergency area identified in the public health emergency declaration;
(2) to hospitals that have instituted a disaster protocol; and
(3) for up to 72 hours from the time the hospital implements its disaster protocol.
When the Presidential or Secretarial declaration terminates, a hospital must then comply with all the requirements of the Privacy Rule for any patient still under its care, even if 72 hours have not elapsed since implementation of its disaster protocol.
March 13, 2020: Waiver or Modification of Requirements Under Section 1135 of the Social Security Act
The Waiver was implemented “to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in the Medicare, Medicaid and CHIP programs and to ensure that health care providers that furnish such items and services in good faith, but are unable to comply with one or more of these requirements as a result of the consequences of the 2019 Novel Coronavirus (previously referred to as 2019-nCoV, now as COVID-19) pandemic, may be reimbursed for such items and services and exempted from sanctions for such noncompliance, absent any determination of fraud or abuse.”
February 2020: BULLETIN: HIPAA Privacy and Novel Coronavirus
This bulletin was released “to ensure that HIPAA covered entities and their business associates are aware of the ways that patient information may be shared under the HIPAA Privacy Rule in an outbreak of infectious disease or other emergency situation, and to serve as a reminder that the protections of the Privacy Rule are not set aside during an emergency.”
HHS – Emergency Situations: Preparedness, Planning, and Response
Contact us at Kentucky REC with your questions. We’re here to help and are available at 859-323-3090.
IN THE MIDST OF COVID-19 KENTUCKY REC IS HERE FOR YOU!
As we enter this unprecedented time of a national emergency due to COVID-19, our team at Kentucky REC wants you to know that we are here to help you and your healthcare organization. We will continue to monitor the situation with federal government programs and policies and keep you updated with anything that might affect you.
We support and appreciate your efforts amid the stress and added workload on your organization due to COVID-19.
Here are some external resources for COVID-19 information:
UK Healthcare Questions and Answers about COVID-19
Kentucky Cabinet for Health and Family Services COVID-19
Contact us Kentucky REC with your questions. We’re available at 859-323-3090.
JOIN OUR TEAM – KENTUCKY REC IS LOOKING FOR A QUALITY AND VALUE MANAGER
Kentucky REC has an opening for a Quality and Value Manager. This person will work with the Kentucky REC Managing Director and executive leadership to ensure quality and value goals are met. This position will lead a team of advisors in assisting practices in developing and implementing strategic plans for process improvement, clinical innovation and/or quality improvement projects (i.e., alternative payment models, quality and value-based care programs such as patient-centered medical home, pay-for-performance, Value Based Modifier, MACRA, MIPS, ACO, and Bundled Payment initiatives); develop and maintain tools to facilitate and support clients; and ensure timely and consistent communication to stakeholders on progress, impacts, and changes associated with management of a services portfolio. Further details here.
Contact us Kentucky REC with your questions. We’re available at 859-323-3090.
QPP WEBINAR MARCH 19: YEAR 4 QUALITY CATEGORY
For 2020, Kentucky REC Quality experts are hosting a *series of three webinars in which they will discuss each of the four MIPS categories, starting with a deep dive into the Quality category. This category carries not only the highest weight of the four, but also has the longest reporting period.
Strong performance in the Quality category is essential to avoiding the negative payment adjustment. It is also has the biggest impact on your potential for exceptional performance status, which requires a score of 85+ points, and qualifies you for an additional positive payment adjustment factor outside the budget neutral program.
Our experts will share the changes to Quality for 2020, and how ongoing monitoring and improvement is essential in your overall success in the Quality Payment Program. During this first webinar of the series we will discuss ways you can be successful in the Quality performance category and maximize your performance in Program Year 4 no matter your practice size, level of submission, or method of collection. We want to help you not only meet the minimum threshold, but thrive in the Quality Payment Program.
Webinar – QPP Categories Year 4: Quality
Thursday, March 19, 2020 12:30 PM ET
Next in the series:
May 21 – QPP Categories Year 4: Cost
July 16 – QPP Categories Year 4: Promoting Interoperability & Improvement Activities
All QPP Webinars start at 12:30 PM ET
*This webinar is for Kentucky REC contracted QPP clients only. If you are interested in this topic and would like to learn more about becoming a client, please contact us at (859) 323-3090 or Kentucky REC. We aim to be your trusted healthcare advisor!
Future dates subject to change
Deadline Extended! Due the #COVID19 National Emergency, the #deadline for the #Kentucky #MedicaidEHR #IncentiveProgram is now 4/30/2020! Read the @KentuckyREC #blog below for more details. https://www.kentuckyrec.com/kentucky-medicaid-ehr-incentive-program-promoting-interoperability-deadline-extended/
Join @KentuckyREC 3/26 for our #HIPAA #Webinar we will discuss changes with the #COVID19 #nationalemergency along with HIPAA #PrivacyandSecurity, and #VulnerabilityScans. #Contactus with your #questions: 859-323-3090 or KYRec@uky.edu
https://www.kentuckyrec.com/webinar-march-26-hipaa-security-find-vulnerabilities-before-attackers-do/
Gyms are closed but it’s still important to take care of yourself!
@ukcampusrecwell is offering virtual group fitness classes for students, faculty and staff beginning tomorrow.
Sign up at https://uky.az1.qualtrics.com/jfe/form/SV_4ZP3Q4LC9YH6lCt. #BetterTogetherUKY https://twitter.com/ukcampusrecwell/status/1242541947731968001
VIRTUAL group fitness starts tomorrow! Check our the schedule for Wednesday-Friday this week. All classes will be taught in real-time. Registration is required prior to participation. Sign up now ➡️ http://ow.ly/6eQl50yUBR2
