CMS Proposes Changes to MIPS for the 2020 Reporting Year
In January 2019, #PTTRANSFORMS published answers to some common MIPS questions. The Centers for Medicare and Medicaid Services (CMS) recently released its proposed Physician Fee Schedule for 2020, which includes 4 major changes to MIPS that are relevant to physical therapists (PTs).
1. Increase in the Minimum Number of MIPS Points for a Neutral Payment Adjustment
Under MIPS, providers earn points for Quality Performance Measures and Improvement Activities—2 required categories for PTs. In addition, submitting MIPS data via a qualified clinical data registry, such as APTA's Physical Therapy Outcomes Registry, could earn practice points in the Promoting Interoperability category.
In 2019, to receive a neutral payment adjustment, a provider must earn 30 points. Under the CMS proposed rule that number would increase to 45 in the 2020 reporting year.
2. New Measures for Physical and Occupational Therapy
CMS is proposing to add several new measures to the physical therapy and occupational therapy set of measures. These include:
- Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy – Neurological Evaluation
- Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention – Evaluation of Footwear
- Preventive Care and Screening: Screening for Depression and Follow-Up Plan
- Falls: Risk Assessment
- Falls: Plan of Care
- Falls: Screening for Future Fall Risk
- Elder Maltreatment Screen and Follow-Up Plan
- Preventive Care and Screening: Tobacco Use: Screening and Cessation in Intervention
- Dementia: Cognitive Assessment
- Functional Status Change for Patients with Neck Impairment
APTA is pleased to see additional measures added to the set to allow therapists more measures to choose from that meet their practice needs and patient populations.
3. Increase in Required Data Completeness
For the Quality category, currently providers are required to submit data for at least 60% of Medicare Part B patients seen that year. CMS is proposing to increase that number to 70% for the 2020 reporting year.
4. Change in Requirement for Improvement Activity Credit for Groups
Currently, groups, including virtual groups, can attest to an improvement activity if at least 1 clinician in that group participates in that activity. However, under the proposed rule, at least 50% of group members would need to participate in or perform that activity, for the same continuous 90-day period in order to get credit for that activity.
For more information on the entire Medicare Physician Fee Schedule proposed rule, you can listen to APTA's August 15, 2019, Insider Intel webinar, available free to members. A follow-up live webinar is scheduled for later this year, after the rule is finalized.
APTA's September Flash Action Strategy: Student-Led, Member-Powered
This year's Flash Action Strategy (FAS) will take place September 18 and 19, and you can help make it the biggest ever.
What Is FAS?
Flash Action Strategy is an annual student-led campaign in which students, educators, and clinicians use social media and email to educate members of Congress about legislative priorities that impact the physical therapy profession. First held in 2013, FAS has resulted in more than 32,000 emails to legislators.
Social media has become a powerful advocacy tool. Many congressional offices have a dedicated staff member who works on social media, and just a few constituents tweeting about an issue can catch the attention of legislative staff.
This year's goal: to increase the number of cosponsors of the Physical Therapist Workforce and Patient Access Act.
What Is the Physical Therapist Workforce and Patient Access Act?
The legislation, known as H.R. 2802 in the House of Representatives and S. 970 in the Senate, would allow PTs to participate in the National Health Service Corps (NHSC) Loan Repayment Program, which repays up to $50,000 in outstanding student loans to certain health care professionals who agree to work for at least 2 years in a designated Health Professional Shortage Area (HPSA).
The addition of physical therapists to the NHSC Loan Repayment Program will ensure that the 11.4 million individuals in rural and underserved areas have access to nonpharmacological options for the prevention, treatment, and management of pain. Currently, there is no rehabilitative component within the NHSC.
H.R. 2802, which has 48 cosponsors as of this writing, was introduced by Reps Diane DeGette (D-CO) and John Shimkus (R-IL). S. 970 was introduced by Sens John Tester (D-MT), Roger Wicker (R-MS), and Angus King (I-ME) and has 6 cosponsors. (Download APTA's Action App to track the most up-to-date numbers.)
How You Can Participate in #FAS2019?
Get social. The event may be student-led, but everyone can participate! You don’t have to worry about developing your own message or not knowing what to say. APTA has developed messages through the Legislative Action Center for you to use on social media and in emails you can send directly to your members of Congress. It takes only a few minutes to participate, and your reach is wide. It’s already impactful for one person to engage with their legislators on social media, but imagine the influence of several thousand emails and tweets over the course of 2 days, echoing the same message.
- Tell your legislators how the NHSC Loan Repayment Program will affect you
- Tell your legislators what it’s like to be a PT – education is important!
- Tag your posts #FAS2019 to join in the conversation
- Follow @APTAtweets for graphics and other ways to spread the message
Use the APTA Action App.
APTA's app, available for both Android and Apple, makes it easy to for you to contact your members of Congress any time.
Using the app, you can:
- Hit the Federal Action Center button to contact your members of Congress.
- Check for talking points on key issues.
- Look up your senators and representative.
Give to PT-PAC.
Send letters through the Legislative Action Center. This resource allows members to send form letters—that you can personalize—to your members of Congress.
Sending letters in tandem with our social media messages is a great way to get the attention of lawmakers and staff. Visit www.apta.org/TakeAction for more information.
Things to Remember
- Encourage others to participate, to increase our voice.
- Stay on message. We are more powerful when we are all asking for the same thing.
- Include the correct bill numbers (H.R. 2802 for the House of Representatives, S. 970 for the Senate) in your messages.
- Refer to members of Congress with their proper titles.
- Tag your posts with legislators who are not your own. Use the APTA Action App or visit Congress.gov to find out who your legislators are.
- Be negative or partisan.
- Forget to tag your legislators and use the hashtag #FAS2019.
- Post more than 10 times in a day.
There is strength in numbers, and APTA member advocacy is powerful. Due to previous advocacy efforts of members and APTA staff, we have successfully worked to:
- Establish locum tenens for PTs.
- Improve coordination of rehab research through the 21st Century Cures Act.
- Enable PTAs to be covered under TRICARE.
- Eliminate the hard therapy cap under Medicare.
But none of this would have occurred if we didn't educate legislators about how these issues affect their constituents.
Help make a difference on September 18-19 for the physical therapy profession, and for your patients.