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CMS Updates QPP Participation Status Tool

The Centers for Medicare & Medicaid Services (CMS) has refreshed its Quality Payment Program Participation Status Tool based on a third snapshot from entities participating in alternative payment models (APMs). The tool includes 2018 Qualifying APM Participant (QP) and Merit-based Incentive Payment System (MIPS) APM status.

The third data snapshot covers Medicare Part B claims with dates of service from Jan. 1 to Aug. 31, 2018. For Medicare Shared Savings Program participants, a fourth Dec. 31, 2018, snapshot will determine which eligible clinicians (ECs) participate in a MIPS APM for purposes of the APM scoring standard.

QPs are eligible for a 5 percent APM incentive bonus and exempt from MIPS participation. To check QP and MIPS APM status at the individual level, health care providers must enter their 10-digit National Provider Identifier on the QPP Status Tool. To check eligibility at the APM entity level, providers must log in to the QPP website and use their group’s taxpayer identification number to locate each clinician’s eligibility status.

View the QP Methodology Fact Sheet for more information about how CMS determines QP and APM status. CMS also published a Medicare Shared Savings Program and QPP Interactions Guide that includes:

  • an overview of 2019 Shared Savings Program participation tracks;
  • an overview of the APM scoring standard and eligibility for ECs participating in Shared Savings Program accountable care organizations (ACOs);
  • information about how ECs participating in ACOs are scored under MIPS if their Shared Savings Program Participation agreement is terminated during the performance year; and
  • a description of how CMS identifies QPs for ECs participating in an ACO and meeting advanced APM criteria.

For questions, contact the Quality Payment Service Center at 866.288.8292 or qpp@cms.hhs.gov. Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Emily Schweich is a communications associate for America's Essential Hospitals.