The Centers for Medicare & Medicaid Services (CMS) is accepting public comments on the Calendar Year (CY) 2027 Medicare Physician Fee Schedule Proposed Rule, and clinicians, patients, caregivers, and cardiovascular health advocates have an important opportunity to make their voices heard. Comments must be submitted by September 14, 2026.

We are all in favor of the proposed rule to add a new Low-Density Lipoprotein Cholesterol (LDL-C) Monitoring and Management quality measure to the Merit-based Incentive Payment System (MIPS). Medicare payment incentives for lipid management are presently tied to prescription of statins rather than response to lipid-lowering therapy (achieved LDL-C). This is an inefficient and ineffective incentive structure. The proposed change moves us closer to an outcomes-based rather than process-based measure. The present approach was more in line with 2013 rather than contemporary guidelines of care.

The proposed measure, stewarded by the American Heart Association (AHA), focuses on adults with clinical atherosclerotic cardiovascular disease (ASCVD). We expect to target broader patient population at a later date – this is a starting point. The measure assesses two important elements of care: whether patients receive guideline-directed LDL-C testing and whether their most recent LDL-C level is below 70 mg/dL. View the measure below.

The measure is valuable because:

1. ASCVD continues to impose a significant public health concern
2. Elevated LDL-C has been conclusively established as a causal factor in atherosclerosis and is recognized as a major driver of ASCVD risk
3. LDL-C reduction is associated with reduced ASCVD risk.
4. The measure aligns with the 2026 American College of Cardiology (ACC)/American Heart Association (AHA)/Multisociety Guideline on the Management of Dyslipidemia
5. The measure addresses an important gap in existing quality programs

Public comments and public participation tell CMS what matters to clinicians and patients. Together, the National Lipid Association (NLA), National Forum for Heart Disease & Stroke Prevention, and WomenHeart encourage you to provide comment in support of the LDL-C Monitoring and Management quality measure. We also encourage you to share this opportunity with colleagues and friends.

Considerations in Making a Public Comment

Whenever possible, public comments should be personalized. Please be sure to include the following in your comment:

1. Reference to file code CMS-1848-P
2. Statement of support of the “Low-Density Lipoprotein Cholesterol (LDL-C) Monitoring and Management quality measure in the CY 2027 Physician Fee Schedule”

You can download template content in inform your comment using the button below:

MIPS Quality Measure

Proposed for the CY 2027 Performance Period/2029 MIPS Payment Year & Future Years

Low-Density Lipoprotein Cholesterol (LDL-C Monitoring and Management