January 22, 2021 

REMINDERS

Innovation Payment Contractor (IPC) Portal Access Survey for PY2021 DCEs

Respondents to the survey will receive the IPC Portal User Manual early next week, which will outline the process for accessing the IPC Portal through the CMS Enterprise Portal, and submitting banking information. As a reminder, respondents will need to submit their banking information by February 7th, 2021 in order to ensure timely payments in April. Should you have any questions regarding the process, please reach out to the Direct Contracting Model Team at [email protected].

New Exceptions Released For Adding Mid-Year DC Participant Providers

DC Participant Providers and Preferred Providers can be added mid-Performance Year as part of an ad hoc process; however, DC Participant Providers that are added mid-Performance Year will not contribute to claims-based alignment for that PY and will not be eligible to participate in payment mechanisms (Total Care Capitation, Primary Care Capitation, and Advanced Payment). Further, DC Participant Providers can only be added if the provider in question (1) bills (at the time of the addition) for items and services he or she furnishes under a TIN that is used by a provider in the same DCE, and (2) did not bill under that TIN when the DCE submitted its provider list. However, new exceptions to the above two requirements are now available:

  • If the DC Participant Provider bills under a TIN that has been acquired by or merged with an existing TIN on your DC Participant Provider list since the window to add provider closed (i.e., since 10/23/20), or
  • If the DC Participant Provider was dropped from the DCE’s final DC Participant Provider list due to overlaps with another CMMI model or the shared savings initiative (e.g., Medicare Shared Savings Program) and that overlap has since been resolved.

Additional guidance will be released in the coming weeks to further explain the ad hoc process (including compliance and documentation protocols) as well as provide instructions on how to update a TIN for a provider that is on your current approved provider list.

Recently Held: Introduction to PY2021 Model Work Streams Webinar

Thank you to all the PY2021 DCEs that attended the Introduction to the PY2021 Work Streams webinar held on January 13.  The slides and recording can be found in the Knowledge Library in 4i under Model Resources, in the General Resources section.

Timing of Stop-Loss Charge Information

For DCEs participating in PY2021, CMS does not expect to be able to calculate and release each DCE’s PY2021 stop-loss charge until early April, shortly after the start of the Performance Year (and therefore after the deadline to sign your Participation Agreement). Once DCEs receive their stop-loss reinsurance information, you will be provided with ~30 days to review and determine whether to elect the stop-loss reinsurance option for PY2021. Other details of the stop-loss methodology, such as the attachment points, will be provided in advance of the Performance Year – only the stop-loss charge information based on historical experience will be outstanding.

Beneficiary Claims Data API (BCDA) and API Credentials

In line with CMS’s Cloud First strategy, the Innovation Center (CMMI) is actively working towards delivering data to our model participants via application programming interface (API) tools. In 2021, CMS will begin a pilot to allow DCEs access to their Claim and Claim Line Feed (CCLF) data via API. The pilot will leverage the Beneficiary Claims Data API (BCDA), which is currently used by the Medicare Shared Saving Program (MSSP). The outreach for pilot participants will be communicated via this newsletter in coming weeks. 

In your 4Innovation (4i) Portal, you can now see the ‘API Credentials’ tab in the left menu. Eventually, this feature will allow pilot participants to receive their data via API. Currently, this feature is not active and cannot be utilized to access any API. More information on the pilot will be available soon.

It’s Time to Update Your “Standard Password”

CMS IT Security Policy does not allow us to exchange encryption passwords via email. We must call each other and verbally exchange them unless we use a “standard password.” In Direct Contracting, we have opted to use a standard password with a calendar year embedded in the code. Now that it is 2021, this is a reminder to update your standard password to DXXXX$2021dce. The first letter of the standard password is capitalized. The last three letters are lower case. Use the 2021 password even if the file concerns prior year data or issues. The password changes with the calendar year, not the underlying data within the file.

Is Your DCE Receiving all Direct Contracting Communications?

Please be sure to add the model e-mail address [email protected] to your favorites so that CMS communications do not go into your junk or spam folder. Additionally, please forward our communications to the relevant members of your DCE. If someone in your DCE is not on our distribution list, please add them as a contact in 4i following the instructions in the video, How to Add APM User, at this page: https://4innovation.cms.gov/video-resources.

UPCOMING EVENTS

The Following Events are for all DCEs Participating in PY2021

THIS THURSDAY: Introducing the Value-Based Care Direct Contracting Learning System

January 28, 3:00-4:00 PM ET

Please join us on for the first Value Based Care Learning System webinar. In this event, we will:

  • Describe how the learning system can support participants in achieving success within the Direct Contracting model
  • Highlight how model participants can contribute to learning events and share feedback on curriculum plans

As part of this event, we will also discuss how model participants can create and use driver diagrams to facilitate strategic planning within their organizations. This webinar will conclude with a Q&A session followed by next steps. We welcome your questions and feedback about this and future learning system events [email protected]. 

Click here to register for this event.

HELPDESK QUESTION OF THE WEEK

Q: When are the paper based voluntary alignment templates due for the Implementation Period and where can the reporting templates be found?  

A: The template used by DCEs to report Paper-Based Voluntary Alignment can be found attached to this newsletter as well as in in the Knowledge Library in 4i under Model Resources.  For IP DCEs, there is one remaining deadline for submission of this template for alignment effective 4/1/2021: February 24, 2021. Instructions on completing this template can be found on the first tab within the template.  As this submission contains PHI, please encrypt the Excel file using the Standard Password Instructions and e-mail it to [email protected] by Midnight on Wednesday, February 24, 2021.

DATES TO KNOW

Date(s)

Activity

October 1, 2020

Implementation Period Began

January 28, 2021

Introduction to Direct Contracting Learning System Webinar

February 7, 2021

Confirm Banking Information in the IPC Portal

February 24, 2021

IP-Paper based voluntarily aligned beneficiary list due to CMS, 2nd collection

April 1, 2021

PY2021 Begins

Centers for Medicare & Medicaid Services (CMS) has sent this update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.  

Questions?  

Direct Contracting Model Website: https://innovation.cms.gov/innovation-models/direct-contracting-model-options 

Contact DC Model Helpdesk at [email protected] or call us at 1-888-734-6433 (Option 1, 3) from 8:30 AM to 7:30 PM ET.  TTY: 1-888-734-6563