2018 Quality Payment Program (QPP) proposed rule

November 2017 – Vol. 36, No. 10

On June 20, 2017, the Centers for Medicare & Medicaid Services (CMS) released the 2018 proposed rule for the second year of the Quality Payment Program (QPP). The QPP has two tracks for participation: Merit-based Incentive Payment System (MIPS) and Alternative Payment Model (APM). In the August 2017 issue of the Bulletin, the Academy discussed CMS’ proposed changes, including:

  • Increasing the low-volume threshold to ≤$90,000 in Part B allowed charges or ≤200 Part B beneficiaries, which will exempt more eligible clinicians (ECs) from participation.
  • Implementation of a 12-month performance period for the quality and cost performance categories, and a minimum of 90 days for the ACI and improvement activities. The Academy raised concerns regarding the full calendar year requirement replacing the “pick your pace” periods.
  • The creation of virtual groups for reporting.
  • APM participation requirements, including the Academy’s concerns regarding surgical specialties’ ability to meet the APM revenue threshold.

On August 21, the Academy submitted comments to CMS Administrator Seema Verma regarding the CY 2018 proposed rule, including changes in reporting requirements, classification of measures, and ACI performance category credit, among other topics. Additionally, the Academy published a summary of the 2018 MIPS and APM reporting requirements for otolaryngologists, including details on proposed provisions directly affecting your practices, available here: http://www.entnet.org/content/physician-payment-reform.