Comments on CMS-1744-IFC: Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency

The Health Care Transformation Task Force (HCTTF or Task Force) commented on the Centers for Medicare and Medicaid Services (CMS) final rule with comment period (1744-IFC) addressing regulatory revisions in response to the COVID-19 public health emergency (Final Rule). HCTTF provided comments on the provisions of the Final Rule with a focus on the specific program changes of importance to our members. We also offer CMS strategies to consider in addressing some of the long-term issues that may be created by COVID-19.

Task Force Response Summary

  1. Payment for Medicare Telehealth Services Under Section 1834(m) of the Act. We urge CMS to use this opportunity to modernize its telehealth policies regarding value-based payment models and to temporarily extend waivers of normal telehealth policies for participants in the Medicare Shared Savings Program and models in the Center for Medicare and Medicaid Innovation’s portfolio.
  2. Innovation Center Models.
    1. Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Plan. We request that CMS develop a contingency policy to allow beneficiaries who are unable to safely attend the first core session in-person to still participate in new MDPP cohorts.
    2. Changes to the Comprehensive Care for Joint Replacement (CJR) Model. The Task Force urges CMS to consider extending the Extreme and Uncontrollable Circumstances (EUC) policy to run for 90 days after the end of the PHE. We also encourage CMS to consider the long-term impacts of COVID-19 on CJR and offer an opportunity for feedback through a separate rulemaking.
    3. Alternative Payment Model Treatment Under the Quality Payment Program. CMS should waive payment and patient count thresholds and deem all entities participating in eligible Advanced APMs to have satisfied Qualifying APM Provider (QP) thresholds for the 5% incentive payment for 2020 and 2021 performance; at a minimum do not accelerate the thresholds for 2021. Given the additional volatility in spending in PY2020, when calculating the 5% incentive payments for PY2018 and PY2019 CMS could move the spending to calculate payments back one year to both accelerate PY2018 payments and to avoid the use of 2020 for calculating PY2019 payments.
  3. Change to Medicare Shared Savings Program Extreme and Uncontrollable Circumstances Policy. Current MSSP participants should be allowed to notify CMS by August 31st if they do not wish to be financially reconciled nor held responsible for program requirements for the 2020 performance year without having to fully terminate their agreement.
  4. Addressing the Impact of COVID-19 on Part C and Part D Quality Rating Systems. We encourage CMS to work with measure stewards and plans to develop methodologies to adjust for COVID-19 related impacts on patient self-reported and actual outcomes that are outside of the control of plans. HCTTF also recommends CMS reevaluate the existing disaster relief EUC policy for Stars ratings.


Read the Letter Here