COVID-19 Resources

Federal Requirements

Medicare Quality Payment Program (QPP)

CMS has extended the deadline for submitting 2019 performance data to April 30, 2020. Practices that do not submit data will automatically be granted an exception for "extreme and uncontrollable circumstances" and will not be financially penalized. CMS is still evaluating options for reporting of 2020 performance.

Medicare Shared Savings Program Accountable Care Organizations (ACOs)

CMS has extended the deadline for submitting 2019 performance data to April 30, 2020. Practices that do not submit data will automatically be granted an exception for "extreme and uncontrollable circumstances" and will not be financially penalized. CMS is still evaluating options for reporting of 2020 performance.

MNCM Data Collection

Clinical Data

MNCM measures collected through direct data submission: Most data collection was completed by the end of March. MNCM will work with providers as needed to provide flexibility related to data auditing/validation.

HEDIS measures requiring chart abstraction ("hybrid measures"): MNCM will accept data from health plans to the extent it is available without placing additional burden on provider organizations. For additional information, see health plan section below.

Claims Data

HEDIS measures based on claims data only ("administrative measures"): No changes anticipated.

Cost and utilization measures: No changes anticipated.

Federal Requirements

All CMS hospital reporting programs

2019 performance: Data submission for 2019 Q4 is optional. 2019 performance will be calculated with data for Q1-Q3 if needed.

2020 performance: Data submission for Q1 and Q2 will not be counted in performance measures and is not required. Exception: for the Hospital-Acquired Condition Reduction Program and the Hospital Value-Based Purchasing Program, Q1 2020 data, if submitted, will be included in scoring where appropriate.

MNCM Reporting

Clinical quality measures: Will be affected by federal changes (most measures are obtained through CMS Hospital Compare website).

Cost measures: No changes anticipated.

Federal Requirements

Medicare Advantage Plans

Plans do not need to report quality measures for 2019 performance. Prior year data for HEDIS measures will be used in 2021 Star Ratings for Medicare Advantage plans.

Exchange (MNSure) Plans

No changes announced as of April 7, 2020.

State of Minnesota Requirements

Medicaid Plans

DHS and MDH will allow health plans to request a waiver to report prior year rates if unable to complete chart reviews for this year. (Source: March 28, 2020 memorandum to health plans from MDH and DHS)

Commercial Plans

MDH will allow health plans to request a waiver to report prior year rates if unable to complete chart reviews for this year. (Source: March 28, 2020 memorandum to health plans from MDH and DHS)

NCQA Requirements

Medicare Advantage Plans

Following CMS guidance, plans do not need to report quality measures for 2019 performance. NCQA will not publish Health Plan Ratings in 2020.

Medicaid Plans

For HEDIS measures requiring chart audits ("hybrid" measures), plans may report prior year audited data for accreditation purposes if they have lower rates this year that are the result of barriers to obtaining chart data from providers. NCQA will not publish Health Plan Ratings in 2020.

Commercial Plans

For HEDIS measures requiring chart audits ("hybrid" measures), plans may report prior year audited data for accreditation purposes if they have lower rates this year that are the result of barriers to obtaining chart data from providers. NCQA will not publish Health Plan Ratings in 2020.