On June 30, the Centers for Medicare & Medicaid Services (CMS) issued a much anticipated rule outlining proposed payment and policy changes to the new Medicare Part B Quality Payment Program (QPP) that was created by the Medicare Access and Chip Reauthorization Act of 2015 (MACRA). The proposed rule seeks to offer additional flexibility and programmatic support to eligible clinicians, particularly those in small practices, and continues to phase in QPP reporting obligations and payment adjustments.
The proposed rule reiterates MACRA’s goals and continues the core principles of the QPP, including its two pathways for eligible clinicians: (1) the default Merit-based Incentive Payment System (MIPS) path, which includes upward or downward payment adjustments based on scores in four performance categories, and (2) the Advanced Alternative Payment Model (Advanced APM) path for clinicians who meet the criteria of a Qualifying APM Participant (QP) in an Advanced APM. The proposed rule includes key changes impacting both pathways and provides detail on new policies that become effective in and after Year 2 of the QPP. Continue Reading