Rule2021-15652
Medicare Program; Calendar Year 2021 Alternative Payment Model (APM) Incentive Payment Advisory for Clinicians-Request for Current Billing Information for Qualifying APM Participants
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
July 22, 2021
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
This advisory is to alert certain clinicians who are Qualifying APM participants (QPs) and eligible to receive an Alternative Payment Model (APM) Incentive Payment that CMS does not have the current billing information needed to disburse the payment. This advisory provides information to these clinicians on how to update their billing information to receive this payment.
Full Text
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<title>Federal Register, Volume 86 Issue 138 (Thursday, July 22, 2021)</title>
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[Federal Register Volume 86, Number 138 (Thursday, July 22, 2021)]
[Rules and Regulations]
[Page 38569]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-15652]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Part 414
[CMS-5534-N]
Medicare Program; Calendar Year 2021 Alternative Payment Model
(APM) Incentive Payment Advisory for Clinicians--Request for Current
Billing Information for Qualifying APM Participants
AGENCY: Centers for Medicare & Medicaid Services (CMS), Health and
Human Services (HHS).
ACTION: Payment advisory.
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SUMMARY: This advisory is to alert certain clinicians who are
Qualifying APM participants (QPs) and eligible to receive an
Alternative Payment Model (APM) Incentive Payment that CMS does not
have the current billing information needed to disburse the payment.
This advisory provides information to these clinicians on how to update
their billing information to receive this payment.
DATES: Updated billing information must be received no later than
November 1, 2021 (see SUPPLEMENTARY INFORMATION for details).
FOR FURTHER INFORMATION CONTACT: Tanya Dorm, (410) 786-2216.
SUPPLEMENTARY INFORMATION:
I. Background
Under the Medicare Quality Payment Program, an eligible clinician
who participates in an Advanced Alternative Payment Model (APM) and
meets the applicable payment amount or patient count thresholds for a
performance year is a Qualifying APM Participant (QP) for that year. An
eligible clinician who is a QP for a year based on their performance in
a QP Performance Period earns a 5-percent lump sum APM Incentive
Payment that is paid in a payment year that occurs 2 years after the QP
Performance Period. The amount of the APM Incentive Payment is equal to
5 percent of the estimated aggregate paid amounts for covered
professional services furnished by the QP during the calendar year (CY)
immediately preceding the payment year.
II. Provisions of the Advisory
The Centers for Medicare & Medicaid Services (CMS) has identified
those eligible clinicians who earned an APM Incentive Payment in CY
2021 based on their CY 2019 QP status.
When CMS disbursed the CY 2021 APM Incentive Payments, CMS was
unable to verify current Medicare billing information for some QPs and
was therefore unable to issue payment. In order to successfully
disburse the APM Incentive Payment, CMS is requesting assistance in
identifying current Medicare billing information for these QPs in
accordance with 42 CFR 414.1450(c)(8).
CMS has compiled a list of QPs we have identified as having
unverified billing information. These QPs, and any others who
anticipated receiving an APM Incentive Payment but have not, should
follow the instructions to provide CMS with updated billing information
at the following web address: <a href="https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1498/QP%20Notice%20for%20APM%20Incentive%20Payment.zip">https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1498/QP%20Notice%20for%20APM%20Incentive%20Payment.zip</a>.
If you have any questions concerning submission of information
through the website, please contact the Quality Payment Program Help
Desk at 1-866-288-8292.
All submissions must be received no later than November 1, 2021.
After that time, any claims by a QP to an APM Incentive Payment will be
forfeited for the CY 2021 payment year.
The Administrator of the Centers for Medicare & Medicaid Services
(CMS), Chiquita Brooks-LaSure, having reviewed and approved this
document, authorizes Lynette Wilson, who is the Federal Register
Liaison, to electronically sign this document for purposes of
publication in the Federal Register.
Dated: July 19, 2021.
Lynette Wilson,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2021-15652 Filed 7-21-21; 8:45 am]
BILLING CODE 4120-01-P
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</html>Indexed from Federal Register on July 22, 2021.
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