DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
7500 Security Boulevard, Mail Stop S3-02-01
Baltimore, Maryland 21244-1850
February 13, 2018
Mr. Anders M. Gilberg
1717 Pennsylvania Avenue NW #600
Washington, DC 20006
Dear Mr. Gilberg:
Thank you for contacting the Centers for Medicare & Medicaid Services (CMS) regarding the 12 months of quality data and the eligibility requirements for Performance Year 2 (2018) of the Quality Payment Program (QPP), specifically as it relates to the Merit-based Incentive Payment System (MIPS).
As you know, the QPP 2018 Final Rule requires 12-months of data for the Quality and Cost performance categories in Year 2. For the 2017 Transition Year, a 12-month reporting period for Quality was also encouraged, but given the participation flexibility through Pick Your Pace, clinicians had the option to report as little as one day of quality data to satisfy the minimum reporting requirements.
Requiring 12-months of quality data reporting moves us towards a more robust program in Year 3 (2019). We would also like to emphasize that in Year 2 (2018), the program is structured so that a clinician can still perform well in MIPS overall, if they put forth efforts in quality and the other performance categories and/or receive bonus points.
Regarding the eligibility requirements, for the 2017 Transition Year, we provided clinicians with basic MIPS eligibility information on the National Provider Identifier (NPI) look-up tool. We intend to make that information available even earlier this year and we're working to ensure that it is user-friendly and accurate. We anticipate making this information public in the first quarter of 2018.