• Are You in an Advanced Alternative Payment Model? CMS Needs a Word With You


    The Centers for Medicare & Medicaid Services says it needs critical financial information for physicians who successfully participated in 2017 in an advanced alternative payment model under the Quality Payment Program. 

    The agency says it is having issues disbursing 2019 APM incentive payments to qualifying participants. To ensure that it has the necessary banking information, CMS is extending the 2019 payment process into 2020. Qualifying practitioners have until Feb. 28 to provide updated banking information that will enable the disbursement of incentive payments. 

    Although most ophthalmologists participate in the Merit-Based Incentive Payment System, the Academy estimates that as many as 10% of ophthalmologists could be qualified participants in advanced APMs. For example, a private practice clinician who spends time during the week at a teaching hospital that is part of an advanced APM may also be a qualified participant. 

    Advanced APM participants who qualified in 2017 earn a 5% lump sum based on their individual payments for Part B-covered professional services in the following year. 

    CMS began disbursing the 2019 APM Incentive Payment on Sept. 26. But after several attempts at paying the listed physicians, CMS found it lacked the necessary banking information. 

    Review CMS’ list (PDF) to see if you’re among those individuals whom the agency is still attempting to pay.