Rule2024-15644
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
July 17, 2024
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 have earned an Alternative Payment Model (APM) Incentive Payment that CMS does not have the current information needed to disburse the payment. This advisory provides information to QPs on how to update their Medicare billing information so that CMS can disburse APM Incentive Payments.
Full Text
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<title>Federal Register, Volume 89 Issue 137 (Wednesday, July 17, 2024)</title>
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[Federal Register Volume 89, Number 137 (Wednesday, July 17, 2024)]
[Rules and Regulations]
[Pages 58071-58072]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2024-15644]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Part 414
[CMS-5541-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 have earned an Alternative
Payment Model (APM) Incentive Payment that CMS does not have the
current information needed to disburse the payment. This advisory
provides information to QPs on how to update their Medicare billing
information so that CMS can disburse APM Incentive Payments.
DATES: July 17, 2024.
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 or exceeds the applicable payment amount or patient count
thresholds for a performance period is a Qualifying APM Participant
(QP) for that year. For payment years 2020 through 2026, which
respectively correspond to the QP Performance Periods for 2018 through
2023, an eligible clinician who attains QP status for a year earns a
lump sum APM Incentive Payment that is paid in the payment year. For
payment years 2020 through 2024, 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 attained QP status in the 2022
performance period and earned a 5 percent APM Incentive Payment for the
2024 payment year based on aggregate paid amounts for the covered
professional services they furnished in the CY 2023 base period.
When CMS processed the 2024 APM Incentive Payments, CMS was unable
to identify a Taxpayer Identification Number (TIN) or TINs associated
with some QPs, and was therefore unable to disburse the payment. To
successfully issue the APM Incentive Payment for the 2024 payment year,
CMS is requesting assistance identifying current Medicare billing
information for these QPs in accordance with 42 CFR 414.1450(c)(8).
CMS has compiled a list of QPs for whom we were unable to identify
any associated TIN to which we can make the APM Incentive Payment.
These QPs, and any others who anticipated receiving an APM Incentive
Payment but have not, should follow the instructions to provide CMS
with updated Medicare billing information at the following web address:
<a href="https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2924/2024-QP-Notice-for-APM-Incentive-Payment.zip">https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2924/2024-QP-Notice-for-APM-Incentive-Payment.zip</a>.
If you have any questions concerning submission of information
through the QPP website, please contact the Quality Payment Program
Help Desk at 1-866-288-8292.
All information must be received by September 1, 2024. After that
date, any claim to an APM Incentive Payment for the 2024 payment period
based on an eligible clinician's QP status for the 2022 QP Performance
Period will be forfeited. To facilitate payment, please include all
required documentation as specified in the previous link. If CMS is
still unable to process the APM Incentive Payment based on the Medicare
billing information received in response to this advisory, the
submitter will not be notified.
CMS will hold all timely submitted information and process the
remaining 2024 APM Incentive Payments simultaneously as soon as
possible after the deadline. It may take up to 3 months to complete the
validation and verification process before these APM Incentive Payments
are disbursed.
III. Collection of Information Requirements
This advisory is intended to alert certain QPs that CMS is
requesting assistance identifying current Medicare billing information
so that we can disburse APM Incentive Payments. This request for
follow-up information is exempt from the requirements of the Paperwork
Reduction Act of 1995 (44 U.S.C. 3501 et seq.) as specified under
implementing regulation 5 CFR 1320.3(h)(9) with regard to the
clarification of responses.
[[Page 58072]]
The Administrator of the Centers for Medicare & Medicaid Services
(CMS), Chiquita Brooks-LaSure, having reviewed and approved this
document, authorizes Chyana Woodyard, who is the Federal Register
Liaison, to electronically sign this document for purposes of
publication in the Federal Register.
Chyana Woodyard,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2024-15644 Filed 7-16-24; 8:45 am]
BILLING CODE 4120-01-P
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</html>Indexed from Federal Register on July 17, 2024.
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