Medicare AdvantageAdministrativeHigh impact
Upcoming deadlines for the 2026 PIP Transformation of Care incentives
Priority Health·Quality & Incentives
We identified it
Aug 18, 2026
Summary
Priority Health has issued a reminder about 2026 PCP Incentive Program (PIP) Transformation of Care eligibility deadlines. Practices must submit care management questionnaires by Sept. 1, 2026, participate in Data Quality Collaborative meetings (with two remaining dates: Aug. 26 and Nov. 4), and attest PCMH designation status by October in the PRA tool. PCPs not properly attested will be removed from applicable measures at year-end settlement.
Action Required
By Sept. 1, 2026: Billing/administrative team must ensure at least one care management questionnaire is submitted per ACN. Contact Priority Health Provider Network Management specialist for questionnaire link. By Aug. 26 or Nov. 4, 2026: ACNs must participate in at least 2 of 4 Data Quality Collaborative meetings with Priority Health data analysts; contact Provider Network Management specialist for meeting details. By October 2026 (during November attestation period): Providers must report PCMH designation status in PRA tool for all PCPs practicing at PCMH-designated practices (BCBSM, NCQA, URAC, or Joint Commission). Update PCP records using batch upload instructions on pages 10-11 of the 2026 PRA Manual. Consequence: PCPs not attested by the October period will be removed from Care Management and Behavioral Health Collaborative Care measure calculations (both numerator and denominator) at year-end settlement, resulting in lost incentive eligibility.