Medicare Program; Alternative Payment Model (APM) Incentive Payment Advisory for Clinicians-Request for Current Billing Information for Qualifying APM Participants, 57980 [2020-20488]
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Federal Register / Vol. 85, No. 181 / Thursday, September 17, 2020 / Rules and Regulations
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[FR Doc. 2020–18883 Filed 9–16–20; 8:45 am]
BILLING CODE 6560–50–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Part 414
[CMS–5533–N]
Medicare Program; Alternative
Payment Model (APM) Incentive
Payment Advisory for Clinicians—
Request for Current Billing Information
for Qualifying APM Participants
Centers for Medicare &
Medicaid Services (CMS), Health and
Human Services (HHS).
ACTION: Payment advisory.
AGENCY:
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
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SUMMARY:
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15:54 Sep 16, 2020
Jkt 250001
payment. This advisory provides
information to these clinicians on how
to update their billing information to
receive this payment.
DATES: This advisory is effective on
September 14, 2020.
FOR FURTHER INFORMATION CONTACT:
Tanya Dorm, (410) 786–2206.
SUPPLEMENTARY INFORMATION:
Seema Verma, having reviewed and
approved this document, authorizes
Vanessa Garcia, who is the Federal
Register Liaison, to electronically sign
this document for purposes of
publication in the Federal Register.
I. Background
[FR Doc. 2020–20488 Filed 9–14–20; 11:15 am]
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
payments 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 2020 based on
their CY 2018 QP status.
When CMS disbursed the CY 2020
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.
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: https://qpp-cm-prod-content.
s3.amazonaws.com/uploads/1112/2020
%20APM%20Incentive%20Payment
%20Notice.pdf.
If you have any questions concerning
submission of information through the
website, please contact the QPP Help
Desk at 1–866–288–8292.
All submissions must be received no
later than November 13, 2020.
The Administrator of the Centers for
Medicare & Medicaid Services (CMS),
PO 00000
Frm 00044
Fmt 4700
Sfmt 4700
Vanessa Garcia,
Federal Register Liaison, Centers for Medicare
& Medicaid Services.
BILLING CODE 4120–01–P
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[Federal Register Volume 85, Number 181 (Thursday, September 17, 2020)]
[Rules and Regulations]
[Page 57980]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-20488]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Part 414
[CMS-5533-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.
-----------------------------------------------------------------------
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: This advisory is effective on September 14, 2020.
FOR FURTHER INFORMATION CONTACT: Tanya Dorm, (410) 786-2206.
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 payments 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
2020 based on their CY 2018 QP status.
When CMS disbursed the CY 2020 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.
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: https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1112/2020%20APM%20Incentive%20Payment%20Notice.pdf.
If you have any questions concerning submission of information
through the website, please contact the QPP Help Desk at 1-866-288-
8292.
All submissions must be received no later than November 13, 2020.
The Administrator of the Centers for Medicare & Medicaid Services
(CMS), Seema Verma, having reviewed and approved this document,
authorizes Vanessa Garcia, who is the Federal Register Liaison, to
electronically sign this document for purposes of publication in the
Federal Register.
Vanessa Garcia,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2020-20488 Filed 9-14-20; 11:15 am]
BILLING CODE 4120-01-P