Quality Payment Program: Shatter QPP Myths With 5 Top Facts

Why This Topic Matters

QPP reporting choices can affect performance scores, eligibility, and payment adjustments. Understanding the current CMS updates helps practices interpret submission requirements, exception options, and program transitions across performance years.

Article Sections

1. Introduction

   An overview of current concerns affecting QPP submissions and the article’s focus on common misunderstandings. It frames the discussion around CMS guidance and recent program updates.

2. Myth 1: Regular MIPS is going away next year.

   Discussion of MIPS program continuity and the timing of broader program changes. It also introduces newer reporting pathways under CMS guidance.

3. Myth 2: There’s no way to get bonus pay for PY 2020.

   Coverage of pandemic-related accommodations and performance year 2020 bonus considerations. The section addresses CMS adjustments to scoring support under QPP guidance.

4. Myth 3: Only small practices get ‘special status’ under MIPS.

   Explanation of how special status determinations are associated with submitted Medicare data and QPP review processes. It outlines provider categories that may be considered for this designation.

5. Myth 4: Under the EUC application reopening, MIPS providers can erase their 2020 submissions.

   Summary of the reopened exception application process and how it relates to 2020 performance-year submissions. The section focuses on the interaction between exception requests and submitted data.

6. Myth 5: If an individual clinician leaves a group in PY 2020, the MIPS payment adjustment goes to the group for payment year 2022.

   Discussion of how payment adjustments relate to individual clinicians, group participation, and reporting identifiers. It addresses payment-year timing in a group practice context.