[Federal Register Volume 87, Number 153 (Wednesday, August 10, 2022)]
[Rules and Regulations]
[Pages 48609-48610]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-17186]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Part 414

[CMS-5537-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 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.

[[Page 48610]]


DATES: Updated billing information must be received no later than 
November 1, 2022 (see SUPPLEMENTARY INFORMATION for details).

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. 
For payment years 2019 through 2024, 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 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 earned an APM Incentive Payment in CY 
2022 based on their CY 2020 QP status.
    When we disbursed the CY 2022 APM Incentive Payments, we were 
unable to verify current Medicare billing information for some QPs and 
therefore unable to issue the payment. In order to properly disburse 
the APM Incentive Payment, CMS is requesting assistance in identifying 
current Medicare billing information for these QPs in accordance with 
42 CFR 414.1450(c)(8).
    We have 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/1968/2022%20QP%20Notice%20for%20APM%20Incentive%20Payment%20Zip%20File.zip.
    If you have any questions concerning submission of information 
through the website, please contact the Quality Payment Program Help 
Desk at 1-866-288-8292.
    All submissions must be received no later than November 1, 2022. 
After that time, any claims by a QP to an APM Incentive Payment will be 
forfeited for the CY 2022 payment year. To make sure we have received 
all updated billing forms, we will process remaining CY 2022 APM 
Incentive Payments during one payment cycle in the beginning of 2023, 
based on updated billing information for QPs received by November 1, 
2022. Payment processing occurs one time after all forms have been 
received.
    The Administrator of the Centers for Medicare & Medicaid Services 
(CMS), Chiquita Brooks-LaSure, 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: August 5, 2022.
Lynette Wilson,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2022-17186 Filed 8-9-22; 8:45 am]
BILLING CODE 4120-01-P