Quality Payment Program: Shatter QPP Myths With 5 Top Facts

Why This Topic Matters

QPP policy changes and COVID-19-related flexibilities can affect reporting obligations, scoring, exception requests, and downstream payment adjustments for Medicare participants. Understanding the current framework helps organizations assess whether CMS updates change their compliance and quality-reporting strategy.

Article Sections

1. Introduction

   An overview of the article’s focus on common misunderstandings about QPP participation and recent CMS updates affecting Medicare providers.

2. Myth 1: Regular MIPS Is Going Away Next Year

   Discussion of QPP program pathways, including how CMS has positioned future MIPS-related models and what remains available for current performance periods.

3. Myth 2: There’s No Way to Get Bonus Pay for PY 2020

   Summary of pandemic-related accommodations and a bonus-related update tied to the 2020 performance year.

4. Myth 3: Only Small Practices Get ‘Special Status’ Under MIPS

   Explanation of special status assignment and the types of MIPS participants and practice settings referenced in the guidance.

5. Myth 4: Under the EUC Application Reopening, MIPS Providers Can Erase Their 2020 Submissions

   Coverage of the reopened exception application process, its timing, and its relationship to submitted performance 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

   Overview of how individual and group-level MIPS reporting is discussed in relation to clinician movement and later payment adjustments.