AUC and 21st Century Care Act will impact QPP in 2018


CMS has proposed policies with respect to the use of Appropriate Use Criteria, and certain policies enacted under the 21st Century Cures Act that affects the Quality Payment Program.

Appropriate Use Criteria (AUC):

The AUC was first introduced in the calendar year (CY) 2016 Physician Fee Schedule Final Rule with Comment Period. More policies were added to the AUC in the CY 2017 Physician Fee Schedule Final Rule. The evidence-based AUC will help clinicians who order and furnish advanced diagnostic imaging services make the most appropriate treatment decisions for specific clinical conditions.

For the 2018 MIPS performance period, CMS proposes adding a new improvement activity that MIPS eligible clinicians could choose if they attest they’re using AUC through a qualified clinical decision support mechanism for all advanced diagnostic imaging services ordered.

21st Century Cures Act

Enacted in 2016, the 21st Century Cures Act contains provisions affecting how CEHRT impacts the Quality Payment Program’s current transition year and future years. The 21st Century Cures Act was enacted after the publication of the Quality Payment Program Year 1 Final Rule. In the Year 2 proposed rule, CMS is proposing to implement the provisions in the 21st Century Cures Act, some of which will apply to the MIPS transition year.

  • Reweighting the Advancing Care Information performance category to 0% of the final score for ambulatory surgical center (ASC) -based MIPS eligible clinicians.
  • Using the authority for significant hardship exceptions and hospital-based MIPS eligible clinicians for the Advancing Care Information performance category the 21st Century Cures Act grants CMS.

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