Rule2022-17186
Medicare Program; 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
August 10, 2022
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 87 Issue 153 (Wednesday, August 10, 2022)</title>
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[Federal Register Volume 87, Number 153 (Wednesday, August 10, 2022)]
[Rules and Regulations]
[Pages 48609-48610]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-17186]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Part 414
[CMS-5537-N]
Medicare Program; 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.
[[Page 48610]]
DATES: Updated billing information must be received no later than
November 1, 2022 (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.
For payment years 2019 through 2024, 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 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
2022 based on their CY 2020 QP status.
When we disbursed the CY 2022 APM Incentive Payments, we were
unable to verify current Medicare billing information for some QPs and
therefore unable to issue the payment. In order to properly 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).
We have 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/1968/2022%20QP%20Notice%20for%20APM%20Incentive%20Payment%20Zip%20File.zip">https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1968/2022%20QP%20Notice%20for%20APM%20Incentive%20Payment%20Zip%20File.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, 2022.
After that time, any claims by a QP to an APM Incentive Payment will be
forfeited for the CY 2022 payment year. To make sure we have received
all updated billing forms, we will process remaining CY 2022 APM
Incentive Payments during one payment cycle in the beginning of 2023,
based on updated billing information for QPs received by November 1,
2022. Payment processing occurs one time after all forms have been
received.
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: August 5, 2022.
Lynette Wilson,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2022-17186 Filed 8-9-22; 8:45 am]
BILLING CODE 4120-01-P
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</html>Indexed from Federal Register on August 10, 2022.
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