For outpatient Medicare beneficiaries with diabetes and who are prescribed antidiabetic agents (e.g., insulin, sulfonylureas), MIPS eligible clinicians and groups must attest to having:
For the first performance year, at least 60 percent of medical records with documentation of an individualized glycemic treatment goal that:
a) Takes into account patient-specific factors, including, at least 1) age, 2) comorbidities, and 3) risk for hypoglycemia, and
b) Is reassessed at least annually.
The performance threshold will increase to 75 percent for the second performance year and onward.
Clinician would attest that, 60 percent for first year, or 75 percent for the second year, of their medical records that document individualized glycemic treatment represent patients who are being treated for at least 90 days during the performance period.
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Objective & Validation Documentation
Objective: Improve diabetes care by defining and documenting individualize glycemic control goals.
Validation Documentation: Evidence of report identifying diabetic patients who are taking diabetes medication and have documented glycemic treatment goals based on patient-specific factors. Include all of the following elements:
1) Diabetic patients prescribed antidiabetic agents – Total number of outpatients who are diabetic and prescribed antidiabetic agents; AND
2) Percentage of that total with glycemic treatment goals – Percentage of outpatient Medicare beneficiaries, who are diabetic and prescribed antidiabetic agents, with documented glycemic treatment goals. The goals must encompass patient-specific factors, including at least: a) age, b) comorbidities, and c) risk for hypoglycemia; AND
3) Annual assessment – Documented evidence of annual assessment for patients receiving glycemic treatment services (e.g., list of patients flagged for reassessment the following year, dated chart notes in an electronic health record).
• A catalog of diabetes prevention resources tailored to various audiences, including racial and ethnic minorities, lesbian, gay, bisexual, transgender, queer and others (LGBTQ+) communities, people with disabilities, and people with limited English proficiency: https://www.cms.gov/files/document/culturally-and-linguistically-tailored-type-2-diabetes-prevention-resource.pdf
• Provider Directory to facilitate diabetes treatment for primary care teams, particularly providers working with Medicare beneficiaries and vulnerable populations who experience a higher prevalence of type 2 diabetes and its complications: https://www.cms.gov/files/document/diabetes-provider-resource-directory.pdf