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CMS Announces Relief from the Quality Reporting Program in Response to COVID-19

On March 22, 2020, the Centers for Medicare and Medicaid Services (CMS) announced it is granting exceptions from reporting requirements and extensions for clinicians and providers participating in Medicare quality reporting programs with respect to upcoming measure reporting and data submission for those programs.

This applies to Skilled Nursing Facility (SNF)  Quality Reporting Program (QRP) and SNF Value-Based Purchasing Program.*

For those programs with data submission deadlines in April and May 2020, submission of those data will be optional, based on the facility’s choice to report. In addition, no data reflecting services provided January 1, 2020 through June 30, 2020 will be used in CMS’s calculations for the Medicare 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. Click here for the full CMS press release.

*For the SNF Value-Based Purchasing Program, qualifying claims will be excluded from the claims-based SNF 30-Day All-Cause Readmission Measure (SNFRM; NQF #2510) calculation for Q1-Q2.

If you have questions about how these restrictions or updates affect your facility, please contact our post-acute care team today

Please continue to monitor our Coronavirus Resources and Information Page and COVID-19 Relief & Operations FAQs for updates.

Pharmacy Benefit Managers: What is Your Plan Paying For?

Pharmacy Benefit Managers: What is Your Plan Paying For?

The world of pharmacy benefits continues to get more complicated, and that is unfortunately not an accident. Pharmacy benefit managers, also known as PBMs, such as Optum, CVS Health, and Express Scripts, cover more than 80% of the American public’s pharmacy needs. Due to their size and control over the pharmacy industry, they can negotiate […]

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Revenue Improvement Case Study: Outpatient Physical and Occupational Therapy

Blue & Co. reviewed publicly available information on a 120 bed, non-profit, acute-care hospital. The data suggested there was revenue improvement opportunity in their outpatient physical and occupational therapy departments. The department had approximately 27,000 patient visits the previous year. During an assessment, we co-validated a significant set of revenue improvement opportunities: charge capture improvement, […]

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