The Alliance of Specialty Medicine commented today on provisions specific to the Value-Based Payment Modifier (VBPM) as described in the recently released Centers for Medicare and Medicaid Services (CMS) 2013 Medicare Physician Fee Schedule Final Rule. While the Alliance recognizes that implementation of the VBPM is challenging for CMS, this and other CMS quality reporting programs pose unique and significant challenges to specialty physicians, diverting time and resources away from direct patient care.