CMS delays enforcement of Appropriate Use Criteria program as part of policies included in CY 2022 physician fee schedule final rule

The Centers for Medicare & Medicaid Services late today released its calendar year 2022 final rule for the physician fee schedule. The rule cuts the conversion factor to $33.59 in CY 2022, as compared to $34.89 in CY 2021, which reflects the expiration of the CY 2021 3.75% payment increase, a 0.00% conversion factor update, and a budget neutrality adjustment. The rule also finalizes several policies to expand access to telehealth for mental health services, including, in certain instances, covering audio-only services. In addition, as urged by the AHA, CMS finalized a delayed implementation of the payment penalty phase of the Appropriate Use Criteria program to the later of Jan. 1, 2023, or the Jan. 1 that follows the end of the COVID-19 public health emergency. Currently, the penalty phase is set to begin Jan. 1, 2022.  
  
“The AHA applauds today’s ruling by CMS to delay the proposed enforcement of the Appropriate Use Criteria (AUC) program as well as to expand access to telehealth for behavioral health services,” said AHA Executive Vice President Stacey Hughes. 
  
For the Quality Payment Program, CMS will implement seven optional Merit-based Incentive Payment System Value Pathways (MVPs) beginning in 2023. MVPs align the reporting requirements of the four MIPS performance categories around specific clinical specialties, medical conditions or episodes of care. CMS also will increase the MIPS performance threshold score clinicians and groups must exceed to receive positive payment adjustments beginning with CY 2024 payment.  For the Medicare Shared Savings Program, CMS modifies its proposed policy by allowing accountable care organizations to report web interface quality measures through the CY 2024 performance year. However, the ACO quality performance standard will include incentives to report the new ACO measure set that the agency adopted in prior rulemaking.