QPP Proposed Rule Released

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would make changes in the second year of the Quality Payment Program (QPP) as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). CMS has proposed a number of changes to the program, many of which are aimed at easing the reporting burden on small practices. A few highlights from the proposed rule include:

  • CMS will again assign a weight of zero to the MIPS Cost Category. Other categories will be weighted as follows: Quality = 60, Improvement Activities = 15, Advancing Care Information = 25
  • CMS has proposed to modestly raise the performance threshold to 15. The performance threshold for the 2019 payment year is three. This means a final score at or above 15 will allow an eligible clinician to avoid a negative adjustment in 2020.
  • CMS is not proposing modifications to the submission criteria for quality measures.
  • CMS will continue to allow eligible clinicians to use electronic health record technology certified to the 2014 edition for the 2018 performance year to receive credit under the Advancing Care Information Category.
  • CMS is proposing additional flexibilities for clinicians in small practices, including adding bonus points to their final MIPS score.
  • CMS is proposing requirements for MIPS participation at the virtual group level.
  • CMS will add performance standards for scoring improvement in the Quality and Cost categories.
  • CMS will begin determining whether eligible clinicians are APM Qualified Participants using an All-Payer Combination Option that looks at a clinicians participation in a Medicare Advanced APM, as well as an Other Payer Advanced APM.

ASE is continuing to analyze this rule and a more detailed and targeted analysis will follow.

Here is a fact sheet on the proposed rule. The proposed rule (CMS-5522-P) can be downloaded from the Federal Register.

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