I have received a ton of questions over the past few years regarding where FQHcs stand with the Quality Payment Program. The truth is, it is a bit confusing so let’s break down to how find out if you (or one of your providers) qualify for the Quality Payment Program.
The first thing to note is that the QPP is specific to Medicare Part B patients. FQHCs may not bill enough Medicare Part B claims to exceed the minimum threshold to be eligible for the MIPS program. Providers should work with administration to find out if they meet the minimum threshold for MIPS. Information for that can be found here. If a provider meets the minimum threshold, they would need to report under the MIPS program to avoid any future Medicare Payment Adjustments.
Many FQHCs participate in the Medicaid EHR incentive program. Providers will still need to participate in that program regardless of participation in MIPS. Some providers may need to report information under both programs to avoid penalties and gain all of the incentive payments available to them.