[Federal Register Volume 85, Number 235 (Monday, December 7, 2020)]
[Rules and Regulations]
[Page 78770]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-26776]



[[Page 78770]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Part 414

[CMS-5533-N2]


Medicare Program; Alternative Payment Model (APM) Incentive 
Payment Advisory for Clinicians--Request for Current Billing 
Information for Qualifying APM Participants--Update

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Payment advisory.

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SUMMARY: This advisory is to update the submission date listed in the 
previous Federal Register document published on September 17, 2020, 
titled ``Medicare Program; Alternative Payment Model (APM) Incentive 
Payment Advisory for Clinicians--Request for Current Billing 
Information for Qualifying APM Participants'' that provides information 
to 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 update allows these clinicians to provide 
information to CMS regarding their billing information by December 13, 
2020 in order to receive this payment.

DATES: December 7, 2020.

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. 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.
    On September 17, 2020, we published the Medicare Program; 
Alternative Payment Model (APM) Incentive Payment Advisory for 
Clinicians--Request for Current Billing Information for Qualifying APM 
Participants (85 FR 57980), where we announced that submissions would 
need to be received no later than November 13, 2020. In this updated 
advisory we are extending this deadline, and submissions would need to 
be received no later than December 13, 2020.
    If you have any questions concerning submission of information 
through the website, please contact the QPP Help Desk at 1-866-288-
8292.
    The Administrator of the Centers for Medicare & Medicaid Services 
(CMS), Seema Verma, 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: December 1, 2020.
Lynette Wilson,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2020-26776 Filed 12-4-20; 8:45 am]
BILLING CODE 4120-01-P