On November 2, 2017, the Centers for Medicare and Medicaid Services (CMS) released a final rule to continue implementation of the Quality Payment Program (QPP) required by the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA). MACRA was bipartisan legislation signed into law in the spring of 2015 to permanently repeal the Sustainable Growth Rate (SGR), streamline quality reporting programs, and provide incentive payments for participation in advanced alternative payment models.

After an initial rulemaking last year, the QPP went into effect January 1, 2017. Based on feedback from stakeholders over the last several months, CMS has finalized some changes to the QPP and its two tracks for Medicare payment in 2018 and beyond: Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs). Some of these changes include:

• Increasing the low volume threshold so more clinicians are exempt from participating in the program
• Offering a new means of participation in MIPS through virtual groups
• Continuing to allow use of the 2014 Edition of Certified Electronic Health Record Technology (CEHRT) without penalty
• Creating a new hardship exception for clinicians in small practices under the Advancing Care Information performance category
• Creating a small practice bonus
• Creating a complex patient bonus
• Automatically weighting the Quality, Advancing Care Information, and Improvement Activities performance categories at 0% of the MIPS final score for clinicians impacted by Hurricanes Irma, Harvey and Maria and other natural disasters

 Click here for a full summary of the final rule. CMS is accepting comments on the final rule until January 1, 2018.