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CMS Quality Payment Program

Friday, November 9, 2018  
Posted by: Thomas Joseph
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QPP Participation Status Tool Now Includes Second Snapshot of 2018 Qualifying APM Participant and MIPS APMs Data

 

The Centers for Medicare & Medicaid Services (CMS) updated its Quality Payment Program Participation Status Tool based on calculations from the second snapshot of Medicare Part B claims data to calculate the Alternative Payment Model (APM) entities threshold scores. The second snapshot are for dates of participation between January 1 and June 30, 2018. As a reminder, the tool includes 2018 Qualifying APM Participant (QP) and MIPS APM status.

By the end of this year, CMS will release the third QP and MIPS APM status data based on snapshots of claims between January 1, 2018 and August 31, 2018. To learn more about how CMS determines QP and MIPS APM status for each snapshot, please view the QP Methodology Fact Sheet.

What Does QP Status Mean?

If you qualify as a QP, this means you are:

  • Eligible for the 5% APM incentive bonus, and
  • Exempt from participating in MIPS.

What Does MIPS APM Participation Mean?

If you are in participating in a MIPS APM you receive the benefit of being scored under the APM Scoring Standard. As a MIPS APM participant we recommend you check the QPP Participation Status Tool to see if you’re eligible for MIPS in 2018.

How Do I Check My QP or MIPS APM Status?

To view your QP or MIPS APM status as an individual:

To check your group’s 2018 eligibility at the APM entity level:

  • Log into the CMS Quality Payment Program website with your EIDM credentials
  • Browse to the Taxpayer Identification Number affiliated with your group
  • Access the details screen to view the eligibility status of every clinician based on their NPI

What APMs are Included in the QPP Participation Status Tool?

The updated Quality Payment Program Participation Status Tool includes the following 2018 Advanced APMs and MIPS APMs:

  • Bundled Payments for Care Improvement Advanced Model (BPCI Advanced)
  • Comprehensive ESRD Care (CEC) Model (LDO arrangement)
  • Comprehensive ESRD Care (CEC) Model (non-LDO two-sided risk arrangement)
  • Comprehensive ESRD Care (CEC) Model (non-LDO one-sided risk arrangement)
  • Comprehensive Primary Care Plus (CPC+) Model
  • Medicare Accountable Care Organization (ACO) Track 1+ Model
  • Medicare Shared Savings Program Accountable Care Organizations – Track 1, 2, 3
  • Next Generation ACO Model
  • Oncology Care Model (OCM) (one-sided Risk Arrangement)
  • Oncology Care Model (OCM) (two-sided Risk Arrangement)
  • Vermont Medicare ACO Initiative (as part of the Vermont All-Payer ACO Model)

For a comprehensive list of APMs, visit the QPP Resource Library.

Questions?

Contact the Quality Payment Program Service Center by:


IPMA
745 McClintock, Suite 340
Burr Ridge, IL 60527

Tel: 312.427.5810
Fax: 312.427.5813
Illinois toll free: 888.869.3338

Engage. Enroll. Connect.