The Rheumatologist
COVID-19 NewsACR Convergence
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Gout Resource Center
      • Axial Spondyloarthritis Resource Center
      • Psoriatic Arthritis
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / CMS Releases 2021 Proposed Rule for the Quality Payment Program

CMS Releases 2021 Proposed Rule for the Quality Payment Program

August 10, 2020 • By From the College

  • Tweet
  • Email
Print-Friendly Version / Save PDF

On Aug. 3, 2020, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the 2021 performance year of the Quality Payment Program (QPP) included in the CY 2021 Medicare Physician Fee Schedule (PFS) Notice of Proposed Rulemaking (NPRM). The ACR RISE registry staff has reviewed and highlighted key proposed policies for the 2021 Merit-Based Incentive Payment System (MIPS) reporting period and how they compare to the current 2020 MIPS reporting period.

You Might Also Like
  • CMS 2020 Quality Payment Program Proposed Rule Contains Key Changes to MIPS Reporting
  • 2019 Proposed Rule for MIPS Performance Year 3
  • Quality Payment Program Year 3 Reporting Changes: What You Need to Know
Also By This Author
  • How and When to Bill Prolonged Services with Direct Face-to-Face Time

According to the CMS, “In recognition of the 2019 Coronavirus (COVID-19) public health emergency and limited capacity of healthcare providers to review and provide comment on extensive proposals, CMS has limited annual rulemaking required by statute to focus primarily on essential policies including Medicare payment to providers, as well as proposals that reduce burden and may help providers in the COVID-19 response.”

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Of note, the proposed changes continue a gradual implementation of category re-weighting and increase to the performance threshold for 2021. By continuing the gradual increases in 2021, providers will see significant shifts in 2022: 30% weighting for the Quality and Cost categories and a performance threshold near 75 points as required by the Medicare Access and CHIP Reauthorization Act of 2015.

The proposed changes are not finalized until the CMS announces the final rule, expected in November. The ACR will review and evaluate the final rule once announced and will provide more information at that time on the impact for practices.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Performance Category Weights

  • Quality: 40% for CY 2021 (45% for CY 2020)
  • Cost: 20% for CY 2021 (15% for CY 2020)
  • Promoting Interoperability: 25% (no change from CY 2020)
  • Improvement Activities: 15% (no change from CY 2020)

Performance Thresholds

  • Performance threshold at 50 points (45 points for CY 2020)
  • 85 points for exceptional performance (no change from CY 2020)

Quality Performance Category Collection Types
The CMS is proposing to remove the CMS Web Interface as a collection type and submission type for groups and virtual groups. There are no other changes from CY 2020.

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

MIPS Participation and Reporting
The CMS is proposing that all MIPS-eligible clinicians, including those in a MIPS Alternative Payment Model (APM), may choose to participate in MIPS as an individual, a group, a virtual group or an APM Entity. The CMS is also proposing to end the APM Scoring Standard beginning with the 2021 performance period.

Quality Measure Benchmarks
The CMS intends to use data submitted during the CY 2021 performance period, rather than the CY 2019 performance period, to benchmark CY 2021 data. This decision is due to concerns that the national public health emergency for COVID-19 impacted data submission in 2020, resulting in a non-representative sample of historic data for CY 2019 that could skew benchmarking results.

Pages: 1 2 | Single Page

Filed Under: Quality Assurance/Improvement Tagged With: Centers for Medicare and Medicaid (CMS), Merit-Based Incentive Payment System (MIPS), Quality Measures, Quality Payment Program (QPP)

You Might Also Like:
  • CMS 2020 Quality Payment Program Proposed Rule Contains Key Changes to MIPS Reporting
  • 2019 Proposed Rule for MIPS Performance Year 3
  • Quality Payment Program Year 3 Reporting Changes: What You Need to Know
  • CMS Releases Additional Updates to MIPS 2019 Submission

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use / Cookie Preferences

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2023 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)