Welcome to the AMP newsletter! You can find previous newsletters on the IHA website under the News & Events tab.
Need To Do
Released Today: MY 2019 Preliminary Quality Reports
Measurement Year (MY) 2019 Preliminary Quality Reports for the AMP Commercial HMO and Medicare Advantage product lines are now available! These reports showcase your organization’s efforts to improve clinical quality and patient experience over the past year. The release includes:
MY 2019 AMP Commercial HMO Report: all measures in the Clinical Quality (excluding opioid measures), Advancing Care Information and Patient Experience domains.
MY 2019 AMP Medicare Advantage Report: all measures in the Clinical Quality domain.
Updated MY 2018 AMP Commercial HMO Report: all measures in the Appropriate Resource Use (ARU) and Total Cost of Care (TCOC) domains — as well as opioid measures in the Clinical Quality domain for affected health plans and physician organizations (POs). Learn more about the re-release on our website.
You have four weeks to review your preliminary reports, check for possible data submission errors, submit questions and file appeals. After that, we’ll finalize the reports and use them for incentive payments, public reporting and awards.
Note: This release does not include AMP Commercial ACO or AMP Medi-Cal Managed Care results.
Questions and Appeals Period: Open Now Through June 26, 2020
Physician organizations can submit questions and/or appeals at any time until June 26, 2020, but we strongly encourage you to submit early, since appeals often require significant follow-up.
Who can submit an appeal?
All POs can submit questions or appeals for MY 2019 AMP Commercial HMO and Medicare Advantage Quality Reports.
POs who were contracted with Health Net, Sharp Health Plan, or Western Health Advantage in 2018 can submit questions or appeals on the updated MY 2018 AMP Commercial HMO ARU and TCOC Report. Check our FAQ page for more details about the MY18 updated result or email us if you have questions.
Email the completed Questions and Appeals Submission Form(s) to appeals@iha.org
Requests for appeals are due by 5:00 p.m PDT on Friday, June 26, 2020. If we don’t hear from you by then, we’ll assume you’ve reviewed and approved your results.
Join Us! MY 2019 Preliminary Quality Reports Webinar: June 2, 2020
IHA staff is hosting a webinar that gives an overview of the preliminary AMP results release, including information about what is included in the reports, how to access and review results, and how to submit a question or appeal. Make sure to register for the webinar below. The session will be recorded and made available for those who cannot join live.
Webinar Recording | Emerging Telehealth Best Practices for COVID-19 and Beyond
Hear CMS, DMHC and other IHA members exchange best practices for telehealth billing and reimbursement in this one-hour recorded webinar. To get the resources discussed in the webinar, download the slides. You can find the webinar and slides, plus more information on IHA’s response to the pandemic, on our COVID-19 page.
Telehealth Tip
Medicare policy allows you to bill the Annual Wellness Visit (G0438-G0439) when its delivered via telehealth, as long as you provide all elements of the AWV. If the patient can self-report elements of the AWV (i.e., height, weight, blood pressure, other measurements deemed appropriate based on medical and family history), those measurements may be included and recorded in the medical record as reported by the patient. Stay up to date on the latest from CMS on their COVID-19 page.
Questions?
Contact us: AMP@iha.org www.IHA.org
Integrated Healthcare Association, 500 12th Street, Suite 310, Oakland, CA
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