If you participated in an advanced alternative payment model (APM) under the 2018 Quality Payment Program (QPP), the Texas Medical Association encourages you to take action now to verify that you have received your 5% APM incentive payment for 2020.
The Centers for Medicare & Medicaid Services (CMS) has begun disbursing the 5% bonus to more than 183,000 clinicians nationwide who achieved “qualifying APM participant” status during the 2018 QPP performance year.
However, more than 22,000 of those clinicians risk not receiving that bonus because CMS has been unable to verify their billing information. The deadline to provide correct billing information is Friday, Nov. 13, CMS said.
Verify that you have received a payment by signing in to the QPP portal or by contacting your APM administrator. If you should have received a bonus but did not, check CMS’ public notice and refer to the Excel spreadsheet linked within the document to review the list of unpaid clinicians and National Provider Identifiers.
If you are on the list, complete the “2020 Incentive Payment Billing Information Collection Form” on the fourth page of the public notice and submit it to the QPP Help Desk by email at QualityPaymentProgramAPMHelpdesk@cms.hhs.gov no later than Nov. 13. Note that this is the only method and email address CMS will use to verify billing information.
It's possible clinicians on the list changed their tax identification number (TIN), or joined new TINs or APM entities since 2018, the performance year on which the 2020 payment is based, CMS said.
To fix this problem, CMS plans to revise how it identifies TINs for qualifying APM participants and will establish a more timely and efficient process in the future, the agency said in the 2021 QPP proposed rule.
Complete details can be found in the 2020 APM Incentive Payment Fact Sheet (zip file). For answers to your APM questions, contact the QPP Service Center at (866) 288-8292.
For QPP help, visit the TMA MACRA Resource Center.