The first performance period for the clinician Quality Payment Program mandated by the Medicare Access and CHIP Reauthorization Act ends on Dec. 31. Clinicians in areas affected by the 2017 hurricane season and Northern California wildfires were granted a special exception from the QPP’s Merit-based Incentive Payment System requirements for 2017. All other MIPS clinicians must submit 2017 performance data by March 31, 2018 to avoid an automatic 4% reduction to payments under the Physician Fee Schedule in 2019. The 2018 QPP performance period begins Jan. 1, and will affect PFS payments in 2020. CMS will require a full year of MIPS quality data and begin to score eligible clinicians on the cost category. In addition, clinicians who did not successfully demonstrate meaningful use of electronic health records in 2016 may apply through Jan. 31 for reconsideration of the associated 2018 payment adjustment. For more on QPP performance requirements, including a MACRA Decision Guide, visit and see the recent AHA webinar on the 2018 QPP final rule.