Medicare Program; Alternative Payment Model (APM) Incentive Payment Advisory for Clinicians-Request for Current Billing Information for Qualifying APM Participants, 58071-58072 [2024-15644]

Agencies

• Centers for Medicare & Medicaid Services
• DEPARTMENT OF HEALTH AND HUMAN SERVICES

[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 [www.gpo.gov]
[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: 
https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2924/2024-QP-Notice-for-APM-Incentive-Payment.zip.
    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