Key Quality Payment Program Changes in 2022 PFS Proposed Rule

If finalized, the Quality Payment Program (QPP) will undergo significant policy changes under the Medicare Physician Fee Schedule (PFS) proposed rule. Most notably, the rule introduced the first seven Merit-Based Incentive Payment System (MIPS) value pathways (MVPs), which will be used to streamline MIPS reporting requirements in the future.

The QPP began in 2017 as a value-based payment model that rewards clinicians for delivering high-quality care and reduces payments for clinicians who fail to meet performance standards. It replaced the flawed sustainable growth rate (SGR) model which was repealed under the Medicare Access and CHIP Reauthorization Act (MACRA).

CMS Proposes 2022 OPPS Rates, Higher Hospital Price Transparency Penalty

CMS is seeking greater hospital price transparency enforcement through the newly proposed Medicare Outpatient Prospective Payment System (OPPS) rule for calendar year (CY) 2022. The rule proposed earlier today would increase the monetary penalty CMS can impose on hospitals that fail to comply with the price transparency requirements that took effect on January 1, 2021. Those requirements include publishing payer-specific negotiated rates and other pricing information on the hospital’s public website and providing a consumer-friendly list of prices for shoppable services.

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