The CY 2027 PFS Proposed Rule includes proposals for the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs), as well as several Requests for Information (RFIs).
Specifically, we’re proposing policies that:
Move towards the full implementation of MIPS Value Pathways (MVPs).
Focus on prevention and wellness in patient care.
Reduce administrative burden.
Promote more meaningful participation that drives quality and value.
2027 Policy Proposal Highlights
Key QPP policies that we are proposing in the CY 2027 Medicare PFS Proposed Rule include:
Sunsetting the traditional MIPS reporting option after the 2028 performance year.
Introducing 3 new MVPs for the 2027 performance year that are related to diabetic disease, hypertension, and hospitalists, and modifying all 27 previously finalized MVPs.
Replacing the outcome/high priority measure requirement for the quality category with a new MIPS core measure requirement.
Revising the MIPS Promoting Interoperability performance category reporting requirements in the CY 2026, 2027, and 2028 reporting periods.
Modifying the APM Performance Pathway Plus (APP Plus) quality measurement set and introducing a new collection type: Medicare Electronic Clinical Quality Measures for Accountable Care Organizations Participating in the Medicare Shared Savings Program (Medicare eCQMs).
Applying Qualifying APM Participant (QP) and Partial QP determinations at the Taxpayer Identification Number/National Provider Identifier (TIN/NPI) level instead of the NPI level.
Overview of RFIs
We are also seeking feedback on RFIs about the following topics:
The future transition to FHIR-based digital quality reporting for QPP including the overall transition timeline, key milestones, and implementation considerations.
Whether we should consider MVP score normalization within an MVP to ensure scoring fairness across MVPs.
Improvements and alternative options to the current star rating assignment methodology for quality measure scores collected under the administrative claims collection type.
How Do I Comment on the CY 2027 Proposed Rule?
The proposed rule includes directions for submitting comments within the 60-day comment period. Comments must be submitted by Monday, September 14, 2026.
When commenting, refer to file code: CMS-1848-P
We don’t accept FAX transmissions.
Use 1 of the 3 following ways to officially submit your comments:
Regular mail: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1848-P, P.O. Box 8016, Baltimore, MD 21244-8016.
Express or overnight mail: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1848-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Additional Resources
Learn more about QPP proposals in the following resources:
As of July 1, 2026, the2027 Self-Nomination period for Qualified Clinical Data Registries (QCDRs) and Qualified Registries is now open. QCDRs and Qualified Registries are Centers for Medicare & Medicaid Services (CMS)-approved intermediaries that collect clinical data on behalf of clinicians for data submission. Only intermediaries that want to participate (and that meet the requirements) as a QCDR and/or Qualified Registry need to complete the Self-Nomination form. Eligible clinicians, groups, virtual groups, subgroups, and Alternative Payment Model (APM) Entities, including Shared Savings Program Accountable Care Organizations (ACOs), that want to report for the 2027 MIPS performance period via the QCDR or Qualified Registry reporting mechanism DON’T need to nominate themselves.
To complete the Self-Nomination form, log in to the Quality Payment Program (QPP) website by 8 p.m. ET on September 1, 2026. A Self-Nomination form must be created for each new and existing QCDR and Qualified Registry:
The 2027 Self-Nomination form is for new or existing approved intermediaries who have had remedial action taken against them.
The 2027 simplified Self-Nomination form is for existing approved intermediaries in good program standing.
If you should have a simplified Self-Nomination form, but are unable to access it, please contact the MIPS QCDR/Registry Support Team (Practice Improvement and Quality Measures Management Support (PIQMMS) Team) at QCDRVendorSupport@gdit.com or RegistryVendorSupport@gdit.com.
Don’t create or submit a new Self-Nomination form for your organization.
For Self-Nomination, ensure that a member of your organization has a Health Care Quality Information Systems (HCQIS) Access Roles and Profile (HARP) account to sign in to the QPP website with the appropriate associated role at all times and that appropriate coverage is in place if the lead Self-Nomination contact person is out of the office. Sharing HARP account credentials with other users isn’t permitted and is considered a security violation. Each individual user must have their own HARP account to log in to the QPP website. Unauthorized or improper use of this system is prohibited and may result in disciplinary action and/or civil and criminal penalties.
