/
EVAA and Data Submission EVAA and Data Submission

EVAA and Data Submission - PowerPoint Presentation

kittie-lecroy
kittie-lecroy . @kittie-lecroy
Follow
342 views
Uploaded On 2019-12-02

EVAA and Data Submission - PPT Presentation

EVAA and Data Submission Control Group CMS Million Hearts Model Technical Assistance Webinar May 15 2019 2 Todays Agenda Allotted Time Topic of Discussion 130 PM 135 PM Eastern Time Session Introduction and Agenda ID: 768847

registry data model mhm data registry mhm model providers records beneficiary evaa visit date provider record 2020 results eligible

Share:

Link:

Embed:

Download Presentation from below link

Download Presentation The PPT/PDF document "EVAA and Data Submission" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.


Presentation Transcript

EVAA and Data SubmissionControl Group CMS Million Hearts® Model Technical Assistance Webinar May 15, 2019

2 Today’s Agenda Allotted Time Topic of Discussion 1:30 PM – 1:35 PM Eastern Time Session Introduction and Agenda 1:35 PM – 1:50 PM Eastern Time Responding to EVAA Results 1:50 PM – 2:05 PM Eastern Time Data Submission Review 2:05 PM – 2:25 PM Eastern Time Live Q&A 2:25 PM – 2:30 PM Eastern Time Available Resources & Closing Remarks

Important Reminders and Announcements 3 Data Submission Deadline: The Performance Year 3 data submission deadline is December 31, 2019. This is your last data submission deadline! Pending Acceptance Response Deadline: New Pending Acceptance records must be either accepted or rejected by June 30, 2019 Bulk Pending Acceptance Functionality: A bulk accept/reject functionality for Pending Acceptance records is available in the MHM Data Registry. This upload file can be found when you select ‘Bulk Upload Actions’ in the My Patient Grid For more information see the Bulk Accept/Reject ‘Pending Acceptance’ Job Aid on the Control Group document library

Responding to EVAA Results

EVAA results were provided in the MHM Data Registry on May 1, 2019 for data submitted in 2018 Overall Status : Provides the status of the record in the MHM Data Registry Alignment Status : Describes if the beneficiary was aligned to your organization (“Aligned”) or to another organization (“Not Aligned”) based on claims data Eligibility Status : Describes the beneficiary’s eligibility for the MH Model EVAA Results in the MHM Data Registry 5

All completed records are subject to claims verification against CMS Chronic Conditions Warehouse (CCW) data If your data in the MHM Data Registry does not match claims data in the CCW, you will receive feedback via the MHM Data Registry and/or emailRecords that cannot be validated against the CCW do not result in payment and will still have a status of ‘Released for Validation’ Records that cannot be validated will remain in the MHM Data Registry for two EVAA cycles for updates. Afterwards, the records are no longer eligible for validation. You will be requested to make updates to your beneficiary records so that the records can be revalidated during the next EVAA cycle EVAA Results in the MHM Data Registry 6

Below are all the statuses that will be used to communicate EVAA results in the MHM Data Registry: EVAA Results in the MHM Data Registry 7   Status Alignment Status Eligibility Status   Description Ineligible N/A Ineligible Beneficiary did not meet eligibility criteria for the MH Model at the time of enrollment Enrolled Aligned Eligible Beneficiary is eligible for the MH Model and aligned to the participant organization Not Aligned Not Aligned Eligible Beneficiary is eligible for the MH Model but not aligned to the participant organization Verify Beneficiary N/A N/A Date of Birth, Gender, and/or Race were not found or did not match with claims data and needs to be verified/corrected Verify Visit N/A N/A Visit Date and/or NPI did not match with claims data and needs to be verified/corrected Pending Acceptance Aligned Eligible Beneficiary is eligible but was not provisionally enrolled in the MH Model and needs to be accepted or rejected

Action Required in Response to EVAA Results 8 Status Action Required Payment Eligibility Ineligible No action needed Not eligible for payment Enrolled and Aligned No action needed Eligible for payment Not Aligned   If applicable, request adjudication within 30 days Not eligible for payment Verify Beneficiary Your organization will be prompted to correct the details for these records in the Registry Payments will be delayed for these records until the next payment cycle as long as the record is corrected and released for validation Verify Visit   Pending Acceptance Your organization must accept or reject the record for enrollment and document the rationale for doing so in the Registry For any records that your organization accepts, you must also complete the record in order to officially enroll the beneficiary Payments will be delayed for these records until the next payment cycle as long as the record is completed and released for validation

Timeline for Responding to EVAA Results 9 You must respond to the EVAA results released on May 1st by June 30, 2019 For Pending Acceptance records, you can respond by: Accepting and completing the record, Rejecting the record, or Leaving the record as pending acceptance (time limit applies – see below) Please resolve records that require action in order to receive appropriate payments for your organization

Data Submission

Managing Providers in the MHM Data Registry 11 Managing Providers in the MHM Data Registry Individuals with the Primary Point of Contact (PPOC) role or Practice Administrator role are now able to manage their provider list in the MHM Data Registry New functions/options include: The MHM Data Registry now includes a required Activation Date for all former, existing, and new Providers within a practice

Editing Providers in the MHM Data Registry Step-by-step instructions to editing Providers In the MHM Data Registry, navigate to the Manage Provider Screen Once you have arrived at the list of your practice’s providers, locate the “Actions” drop-down menu From the “Actions” drop-down menu, click on “Edit Provider” option New providers now require an Activation Date input for the provider to be saved Existing providers now have a null field in the Activation Date that requires an update to save any new changes

Deactivating Providers in the MHM Data Registry Deactivating Providers in the MHM Registry If a provider leaves a participating organization or no longer wants to participate in the Model: Do not delete the provider from the Registry or transfer patient visits from the departing provider to other practice providers Deactivate exiting providers (without deleting them) from the Registry. This ensures patient visits are assigned to a different provider in the Model who will continue their care * Please Note : Following the deactivation of a provider, PPOCs and Practice Administrators may still “Edit Provider”

Deactivating Providers in the MHM Data Registry 14 Deactivating Providers in the MHM Registry 1. To deactivate a user, you will need to provide the following: Date of the provider’s deactivation Reason for their deactivation Next, click “Confirm” (Note: providers cannot be reactivated) A confirmation of the National Provider Identifier (NPI) deactivation will pop-up, and also a reminder to go to the Innovation Center [IC] and deactivate the Provider

Add/Edit Encounter NPI (After Deactivation) in the MHM Data Registry Step-by-step instructions to Add/Edit Encounter NPI (After Deactivation) To add a patient visit for a provider after deactivation, utilize the active NPI list, located in the MHM Data Registry A list of providers will not load until after the visit date is entered Add a visit date using the calendar drop-down selection. The NPI list will load with the providers that were active on the date selected The system will then verify that the NPI selected was active on the date selected If the NPI was NOT active on the date provided: The list will refresh with valid providers, and a message will appear explaining why the provider was not included If a provider is added manually to a patient visit, an Activation Date is required before adding the provider

Review of How to Enter Beneficiary Data16 Helpful Tips: Complete a test upload with less than 10 records before attempting a large bulk upload If you would like to delete beneficiary data in bulk : Change the values of a previously populated Excel data template to ‘Y’ in the ‘Delete Indicator’ field then upload it to delete data from the Registry. If uploading new beneficiaries, or uploading updated data for beneficiaries already in the registry, make sure the ‘Delete Indicator’ field says ‘N.’ If you are editing the ‘MBI’ or ‘NPI’ field you must use the manual interface to make this change When bulk uploading data, the each record’s visit date is generated based on the blood pressure reading Cholesterol data can be up to five years old for a beneficiary’s initial visit, and up to one year old for any follow up visits being documented in the MHM Data Registry

17 Review of Required Data Elements to Complete a Beneficiary Record A data record will be considered ‘complete’ if the following data elements are submitted for the beneficiary: Medicare Beneficiary Identification (MBI) First and Last Name Date of Birth Race and Ethnicity Cholesterol (Total, HDL, LDL) Gender Date of visit Systolic Blood Pressure An attestation to the accuracy of the data Data Lockout On the first of each month, all complete records in the MHM Data Registry are automatically submitted to CMS for validation and locked from editing in the Registry. CMS then validates the Registry records. To edit or update a record before data lockout : Leave at least one mandatory field blank to prevent an auto submission To edit or update a record after data is locked : Submit a ticket to the MH Model Help Desk requesting a data record to be corrected and attach an encrypted file with the correct data points If any non-mandatory data fields are left blank, data points will default to ‘no’, and the record will be considered complete Current smoker (Yes/No) History of Diabetes (Yes/No) History of Atrial Fibrillation (Yes/No) Current statin treatment (Yes/No) Current aspirin therapy (Yes/No) Hypertension treatment (Yes/No) Non-mandatory Data Fields

Ongoing Data Submission 18 Data Submission: Submit clinical and demographic data on any new eligible beneficiaries Submit updated clinical data for each enrolled beneficiary annually to fulfill MH Model requirements – Once annually per beneficiary during their ‘Anniversary Window’ The ‘Anniversary Window’ timeframe is a 5-month window (month 10-14): Based on the initial enrollment visit month Starts on the 10 th month following the enrollment visit month Ends on the 14 th month after the enrollment visit month ‘Anniversary Window’ Example: Enrollment Visit Enrollment Visit Month/ Year Anniversary Window Lost to Follow-up (LTFU) Status Start (enrollment +10 months)End (enrollment +14 months)LTFU StartsLTFU Updated in the Registry Jan 16, 2017 Jan 2017 Nov 1, 2017 Mar 31, 2018 Apr 1, 2018 Jul 1, 2018

Control Group Timeline Important deadlines Final Activities Dates Details/Options Final Data Submission Dec 31, 2019 Data locked as of January 1, 2020 No new visits from 2020 can be added MHM Data Registry Limited Access Jan 1, 2020 through Mar 31, 2020 Access to the MHM Data Registry through Apr 2020 with edit/update/export for 2019 records ONLY Final EVAA Cycle Apr 2020 Final data (as of December 31, 2019) to be processed in April 2020 EVAA cycle Results viewable in May 2020 Final Payments May 2020 Final payments to Organizations (post Final EVAA) Registry Access Closed Jun 2020 Model participation ends– Thank you for your participation! Post Model After final closeout Jun 2020 Continued Help Desk Support Final payments/adjustments (if needed) Model updates available on MH Model website: https://innovation.cms.gov/initiatives/Million-Hearts-CVDRRM/

Question & Answer Submit your questions now by typing them into the green Q&A button at the bottom of your screen

Resources and Thank You! 21 More questions for us? Contact the MH Model Help Desk at 844-711-2664 (option 3) or at mhmodel@ cms.hhs.gov MHM Control Group Document Library: Access links to webinars, job aids, and other Model Resources Review MH Model Team Communications: Reference past reference guides, user manuals, and other resources for information and instructions on navigating Model tools Million Hearts ® Program Officer (MHPO): Schedule a call with your MHPO through the help desk for questions related to tailoring your organization’s participation in the Model to your practice