Language Lesson: Add These Terms to Your MIPS 2019 Glossary to Save Research Time

MIPS 2019 GlossaryWhen MACRA and MIPS come up, does it feel like speaking another language? For the 2019 performance year, there are even some new terms to learn. We’ve got the new language and tips on where you’ll see it used so you don’t have to spend time searching.

Collection Type: Apply to Sets of Similar Quality Measures

According to the Quality Payment Program Year 3: Final Rule Overview. the official definition of collection type is, “a set of quality measures with comparable specifications and data completeness criteria including, as applicable: electronic clinical quality measures (eCQMs); MIPS clinical quality measures (CQMs) (formerly referred to as ‘Registry measures’); Qualified Clinical Data Registry (QCDR) measures; Medicare Part B claims measures; CMS Web Interface measures; the CAHPS for MIPS survey measure; and administrative claims measures.”

Examples: That’s a mouthful, so it helps to see it in context. In the final rule, you’ll see phrases like (bold added) “the list of quality measures available under the eCQM collection type” and “allow small practices to continue using the Medicare Part B claims collection type.”

Don’t miss: Did you catch that registry measures are now called MIPS clinical quality measures (CQMs)? The explanation in the final rule is that entities other than registries may submit those measures.

Submitter Type: Focus on the One Submitting Data

The final rule defines submitter type as “the MIPS eligible clinician, group, or third party intermediary acting on behalf of a MIPS eligible clinician or group, as applicable, that submits data on measures and activities under MIPS.”

In other words: This term, submitter type, includes clinicians as well as entities that submit data on clinicians’ behalf.

Example: In final rule table 32, Data Submission Types for MIPS Eligible Clinicians Reporting as Individuals, the Submitter Type column for Cost lists Individual, while the Submitter Type column for Improvement Activities lists Individual or Third Party Intermediary.

Submission Type: Match This Term to Mechanism

In the Final Rule, the definition for submission type is “the mechanism by which a submitter type submits data to CMS, including, as applicable: Direct, log in and upload, log in and attest, Medicare Part B claims and the CMS Web Interface.”

Here’s some more info on some of those submission types:

  • Direct: Users transmit data through a computer-to-computer interaction. API is an example.
  • Log in and upload: Users upload and submit data in the way CMS specifies using authenticated credentials.
  • Log in and attest: Users manually attest to performance of certain measures and activities. This submission type also involves use of authenticated credentials.

Tip: The administrative claims collection type doesn’t have a submission type. That’s because CMS calculates measures based on the administrative claims data.

What About You?

What terms do you think are most important to understanding MIPS and QPP?

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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