United States Government Publishing Office publisher pbl distributor dst United States National Archives and Records Administration Office of the Federal Register author aut Government Organization text government publication eng FR Regulatory Information 2016_register executive 2018-02-14 article Part II Rules and Regulations D09002ee1c7f33b90 D09002ee1c7f33c9d United States Department of Health and Human Services originator org United States Government Agency or Subagency United States Centers for Medicare & Medicaid Services originator org United States Government Agency or Subagency The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs). Alternative Payment Models are payment approaches, developed in partnership with the clinician community, that provide added incentives to deliver high-quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population. This final rule with comment period also establishes the MIPS, a new program for certain Medicare-enrolled practitioners. MIPS will consolidate components of three existing programs, the Physician Quality Reporting System (PQRS), the Physician Value-based Payment Modifier (VM), and the Medicare Electronic Health Record (EHR) Incentive Program for Eligible Professionals (EPs), and will continue the focus on quality, cost, and use of certified EHR technology (CEHRT) in a cohesive program that avoids redundancies. In this final rule with comment period we have rebranded key terminology based on feedback from stakeholders, with the goal of selecting terms that will be more easily identified and understood by our stakeholders. 81 FR 77008 https://www.govinfo.gov/app/details/FR-2016-11-04/2016-25240 2016-25240 fr04no16-18 RIN 0938-AS69 4120-01-C CMS-5517-FC https://www.govinfo.gov/app/details/FR-2016-11-04/2016-25240 https://www.govinfo.gov/content/pkg/FR-2016-11-04/html/2016-25240.htm https://www.govinfo.gov/content/pkg/FR-2016-11-04/pdf/2016-25240.pdf Administrative Practice and Procedure Biologics Drugs Health Facilities Health Professions Kidney Diseases Medicare Reporting and Recordkeeping Requirements Health Maintenance Organizations (Hmo) Health Records Medicaid Penalties 824 p. 77008 77831 81 FR 77008 Title 42 Part 414 42 CFR Part 414 Title 42 Part 495 42 CFR Part 495 RIN 0938-AS69 Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models; Federal Register Vol. 81, Issue RULE 2016-25240 II DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services CMS-5517-FC 4120-01-C 2016-25240 Final rule with comment period.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs). Alternative Payment Models are payment approaches, developed in partnership with the clinician community, that provide added incentives to deliver high-quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population. This final rule with comment period also establishes the MIPS, a new program for certain Medicare-enrolled practitioners. MIPS will consolidate components of three existing programs, the Physician Quality Reporting System (PQRS), the Physician Value-based Payment Modifier (VM), and the Medicare Electronic Health Record (EHR) Incentive Program for Eligible Professionals (EPs), and will continue the focus on quality, cost, and use of certified EHR technology (CEHRT) in a cohesive program that avoids redundancies. In this final rule with comment period we have rebranded key terminology based on feedback from stakeholders, with the goal of selecting terms that will be more easily identified and understood by our stakeholders.

Effective date: The provisions of this final rule with comment period are effective on January 1, 2017. Molly MacHarris, (410) 786-4461, for inquiries related to MIPS. James P. 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Table of Contents: AE 2.7: GS 4.107: AE 2.106: KF70.A2 https://www.govinfo.gov/app/details/FR-2016-11-04 P0b002ee1986802b2 0097-6326 0042-1219 0364-1406 769-004-00000-9 000582072 f:fr04no16 https://www.govinfo.gov/app/details/FR-2016-11-04 https://www.govinfo.gov/content/pkg/FR-2016-11-04/pdf/FR-2016-11-04.pdf https://www.govinfo.gov/content/pkg/FR-2016-11-04/xml/FR-2016-11-04.xml fdlp 76843 78019 DGPO 2018-02-14 2024-06-01 FR-2016-11-04 machine generated eng FR FR-2016-11-04 81 214