2018 CMS Quality Payment Program

April 18, 2018
The AAAAI has signed on to a letter to CMS Administrator Seema Verna, joining the AMA and a broad range of other organizations expressing concerns about the 2018 Quality Payment Program. The letter specifically requests that the reporting period for 2018 be reduced from the full year to a 90 day period because of the late posting of a provider look-up took for MIPS eligibility and extensive changes to the low volume threshold, making it difficult for physicians to know what was necessary to prepare for 2018 reporting.

February 9, 2018
Congress passed MACRA in 2015, legislation that repealed the sustainable growth rate (SGR) formula. The law also  reformed how Medicare pays providers, as well as consolidated and streamlined reporting systems and their corresponding legacy quality programs to make them easier for providers to interact with and more relevant to their practice of medicine.  After two years it has become clear that certain technical corrections are necessary to ensure the success of the new quality payment program (QPP), allow CMS more time to develop certain measurement tools, correct drafting errors and follow the intent of Congress to maximize the participation of providers and the transition to value based payment.  

Technical corrections to address these issues were included in a Continuing Resolution adopted on February 9, 2018, the Bipartisan Budget Act of 2018. View the technical corrections here.

November 28, 2017
Under its final Quality Payment Program rule released in November, the Centers for Medicare and Medicaid Services (CMS) is applying the MIPS adjustments to Part B drugs, in addition to fee schedule services. In response to this significant departure from current policy, the AAAAI and others contacted Congress to seek intervention. Read more here.

October 9, 2017
Exclusive to the American Academy of Allergy, Asthma & Immunology, this Resource Guide on the Advanced APM Track of the Quality Payment Program complements the Qualifying APM Participant Look-up Tool, recently released by the Center for Medicare and Medicaid Services. It is intended to serve as a quick reference for key aspects of participation under the Advanced APM Track of the Quality Payment Program (e.g. Advanced APM criteria, QP thresholds, and more) and includes information collected across multiple sources, including policies finalized in last year’s rule and additional proposals in the CY 2018 proposed rule.

August 21, 2017
The American Academy of Allergy, Asthma & Immunology provided feedback on the Center for Medicare and Medicaid Services’ ongoing implementation of the Quality Payment Program (QPP), primarily the Merit-Based Incentive Payment System (MIPS), as well as aspects of the Alternative Payment Model (APM) incentive, and the impact on A/I professionals and beneficiaries they serve. See document here.

June 20, 2017
On June 20, 2017, CMS issued its 2018 Medicare Quality Payment Program (QPP) proposed rule, which addresses requirements related to participation under the Merit-Based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (APM) pathways created under the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. Here is a summary of the rule, prepared by Hart Health Strategies, Inc. Please note the Table of Contents and embedded links throughout the summary, which should help you to navigate the rule and easily reference specific sections.

In general, CMS will continue to treat year two of the program as another transition year and largely maintain program flexibility. CMS’ stated goal is to simplify the program, especially for small, independent, and rural practices, while ensuring fiscal sustainability and high-quality care within Medicare.

The AAAAI will be preparing and submitting comments on this proposal. If you have any comments, please contact advocacy@aaaai.org.

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