Advanced APMs: Check for missing 2018 payments by Nov. 13

Washington Connection - November 5, 2020

Medicare Payment Policies

Quality Payment Program

November 5, 2020: Group practices that participated in an advanced alternative payment model (APM) in 2018 and earned the 5% bonus payment should review the Centers for Medicare & Medicaid Services' (CMS') list of qualifying participants (QPs) who remain unpaid and follow instructions on how to claim payments if their QPs are listed. More information can be found in this zip file. CMS distributed 2018 APM incentive payments in September, but the agency indicated there are many QPs it has been unable to locate in order to issue the incentive payments. 

The deadline to provide updated information to CMS is Nov. 13. To give members sufficient time to check the agency's file and submit missing information if necessary, MGMA has urged CMS to either eliminate or extend this date. We will also encourage the agency to conduct more extensive outreach to advanced APMs, provide more information on why it was unable to pay so many QPs, and improve the APM payment process going forward. The file of unpaid QPs, last updated Sept. 28, lists 25,648 clinicians that have not received APM bonuses. Even group practices that have already received an APM bonus payment should check the file for their clinicians' names.
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