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Quality Payment Program (QPP) Support Center

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CMS Releases New Multi-Payer Other Payer Advanced APMs List for 2019


The Centers for Medicare & Medicaid Services (CMS) has published a list of payment arrangements with CMS Multi-Payer Models that are Other Payer Advanced APMs for CY 2019 based on submissions from payers made earlier this year through the Payer Initiated Process and based on the Other Payer Advanced APM criteria in effect. Download it here
Under the QPP's All-Payer Combination Option, State Medicaid Agencies, Medicare Advantage and other Medicare Health Plans, as well as commercial and private payers participating in CMS-sponsored Multi-Payer payment arrangements (CMS Multi-Payer Models), may submit information to CMS about their payment arrangements with eligible clinicians. CMS will determine whether each submitted payment arrangement constitutes an Other Payer Advanced Alternative Payment Model (APM) for a given Performance Year. 
If a payer chooses not to (or is not eligible to) submit its arrangements to CMS, eligible clinicians or APM Entities participating in the payment arrangement may do so.