OMB control number

Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration (CMS-10673)

OMB 0938-1354 · HHS/CMS.

OMB 0938-1354

The Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration (“the Demonstration”) is designed to test whether excluding clinicians who participate to a sufficient degree in certain payment arrangements with Medicare Advantage Organizations (MAOs) from reporting quality under the Merit-based Incentive Payment System (MIPS) will increase or maintain participation in payment arrangements with MAOs similar to Advanced Alternative Payment Models (APMs) and change the manner in which clinicians deliver care.

The latest form for Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration (CMS-10673) expires 2021-10-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form CMS-10673 Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration Form and Instruction
6c_CMS-10673_Revisions to MAQI Threshold Data Submission Form_4-10-2019.pdf Supplementary Document
4_CMS-10673_Revisions to MAQI Qualifying Arrangement Form_4-10-2019.pdf Supplementary Document
1_CMS-10673 MAQI_Supporting Statement - Part A_4-10-2019_Clean.docx (document unavailable) Supporting Statement A
3a_CMS 10673_Crosswalk for Supporting Statement - Part A_4-10-19.pdf (document unavailable) Supplementary Document
CMS-10673_Responses to MAQI Public Comments Received for CMS_4-10-2019.docx (document unavailable) Supplementary Document
Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration Form and Instruction

All Historical Document Collections

201904-0938-016 Withdrawn and continue	Revision of a currently approved collection	2019-04-29
201809-0938-002 Approved without change	New collection (Request for a new OMB Control Number)	2018-09-20