Quality Payment Program Updates
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, and the Centers for Medicare & Medicaid Services (CMS) then replaced it with the Quality Payment Program. Remember – the Quality Payment Program has two tracks you can choose: Advanced Alternative Payment Models (APMs) OR the Merit-based Incentive Payment System (MIPS). AAOS has shared the details of QPP and MIPS, which can be found on our website, here: www.aaos.org/MACRA-DeliveryReform/.
On November 2, 2017, CMS released a final rule with comment period for its Quality Payment Program. The Quality Payment Program final rule did not differ significantly from the proposed rule released last June. AAOS has been working closely with CMS to address many concerns related to the Quality Payment Program, including the need for additional flexibility and simplification, as well as protection for small, solo, and rural practices. Read the entire proposed rule comment letter submitted by AAOS online here. Find the CMS fact sheet on the final rule here: https://www.cms.gov/Medicare/Quality-Payment-Program/resource-library/QPP-Year-2-Final-Rule-Fact-Sheet.pdf. For any questions/comments related to this rule, email email@example.com.
Doctors and other eligible clinicians can begin submitting their 2017 performance data using a new system on the Quality Payment Program website (https://qpp.cms.gov). According to CMS, eligible clinicians will be able to use the new system to submit their 2017 performance data for the Quality Payment Program during the 2017 submission period which runs from January 2, 2018 to March 31, 2018. Eligible clinicians will be required to log into the system. After logging in, the system will connect each eligible clinician to the Taxpayer Identification Number (TIN) associated with their National Provider Identifier (NPI). Eligible clinicians will report data either as an individual or a group.
There are two eligibility look-up tools available to confirm a clinician’s status in the Quality Payment Program. Clinicians who may be included in MIPS should check their National Provider Identifier (NPI) in the MIPS Participation Status Tool, which will be updated with the most recent eligibility data, to confirm whether they are required to submit data under MIPS for 2017.
Eligible clinicians are encouraged to log-in early and often to familiarize themselves with the system. Data can be updated at any time during the submission period. Once the submission period closes on March 31, 2018 (with the exception of the CMS Web Interface, which ends on March 16, 2018), CMS will calculate your payment adjustment based on your last submission or submission update.
To learn more about the Quality Payment Program data submission system, please review this fact sheet or view any of the following training videos:
- Merit-based Incentive Payment System (MIPS) Data Submission
- Advancing Care Information (ACI) Data Submission for Alternative Payment Models (APMs)
- Data Submission via a Qualified Clinical Data Registry and Qualified Registry
Eligible clinicians who need assistance with the data submission system may also contact the Quality Payment Program by email at firstname.lastname@example.org or toll free at 1-866-288-8292. To get the latest information from CMS, visit the Quality Payment Program website.