CMS Releases Final 2018 Quality Payment and Physician Fee Schedule Rules

On Nov. 2, the Centers for Medicare and Medicaid Services (CMS) released the final 2018 Quality Payment Program (QPP) rule and the 2018 Physician Fee Schedule rule.

In the press release announcing these final regulations, CMS Administrator Seema Verma said the rules “reflect the agency’s efforts to promote innovation in health care delivery aimed at lowering prices, increasing competition and strengthening the relationship between patients and their doctors.”

The Physician’s Advocacy Institute (PAI), which is led by North Carolina Medical Society (NCMS) CEO Robert W. Seligson, issued a statement calling the QPP rule a ‘mixed bag’ for physicians.

“The long-awaited Medicare Quality Payment Program final regulation for 2018 is a mixed bag of policies from the physician perspective. We are pleased to see CMS trying to provide continued flexibility for physicians, incentivize small practices to participate and ease the transition to the quality payment program,” Seligson said, adding, “We encourage CMS to further simplify the Quality Payment Program and reduce the burden on physicians as they transition to it.”

As for the 2018 Physician Payment Rule, Seligson in the PAI statement said that “certain aspects of the new rule may miss the mark.” He pledged that PAI will continue to collaborate with CMS to ensure physicians get clarity and patients are not harmed by the complexity of the regulation.

PAI offers the QPP Physician Advocacy and Education Initiative, to offer physician practices the resources they need to navigate the new program.

The AMA also analyzed the new rules and concluded that, while some of their recommendations were left out, CMS did adopt several important policy changes including several to help physicians in small practices. Their analysis projects that 97 percent of eligible clinicians will avoid a penalty in 2020 based on their QPP participation in 2018.

Read the AMA’s summary and analysis of the 1,600 page QPP final rule.

Read the AMA’s summary and analysis of the 1,400 page Physician Fee Schedule rule.


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