CMS Releases All-Payer Guidance – CMS Quality Payment Program

CMS is collecting information and documentation to determine whether payment arrangements qualify as Other Payer Advanced Alternative Payment Models (APMs) under the Quality Payment Program (QPP).

Payers with commercial payment arrangements may submit Other Payer Advanced APM determination requests for those payment arrangements. CMS has released a document to guide payers through the All Payer Submission form for ease of submission and to facilitate accurate determinations by CMS. Commercial payment arrangements must be submitted by June 1, 2019 to be eligible for the 2020 Qualifying APM Participant (QP) Performance Period. For the 2020 QP Performance Period, payers may submit requests until June 1, 2019.

Please note that the submission through the Other Payer Advanced APM determination process is separate from the process of Medicare Health Plans (including Medicare Advantage plans) payment arrangements. The Medicare Health Plans application is occurring now through the Health Plan Management System (HPMS) bidding process with a due date the first week of June. The Other Payer Advanced APM determinations is occurring now through the Salesforce Portal (https://app1.innovation.cms.gov/qpp/qppLogin) with a due date of June 1, 2019.

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.