AAOS May 29, 2018
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Quality Payment Program Updates

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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 more information on our website, here: www.aaos.org/MACRA-DeliveryReform/.

qpp.cms.gov

Use the updated MIPS Participation Lookup Tool to check on your 2018 eligibility for the Merit-based Incentive Payment System (MIPS). Just enter your National Provider Identifier to find out whether you need to participate during the 2018 performance year.

To reduce the burden on small practices, CMS changed the eligibility threshold for 2018. Clinicians and groups are now excluded from MIPS if they:

  • Billed $90,000 or less in Medicare Part B allowed charges for covered professional services under the Physician Fee Schedule (PFS)
  • Furnished covered professional services under the PFS to 200 or fewer Medicare Part B-enrolled beneficiaries

The 2017 data submission period closed Tuesday, April 3, 2018 at 8 PM EDT. At this point, CMS will calculate payment adjustments 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:

  1. Merit-based Incentive Payment System (MIPS) Data Submission
  2. Advancing Care Information (ACI) Data Submission for Alternative Payment Models (APMs)
  3. 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 qpp@cms.hhs.gov or toll free at 1-866-288-8292. To get the latest information from CMS, visit the Quality Payment Program website.