News Feature | May 4, 2016

AMA Responds To MACRA Proposed Final Rule

Christine Kern

By Christine Kern, contributing writer

CMS Two Midnight Rule Alternatives

Rules represent the most sweeping change in physician payment policy in over 20 years.

CMS has released the proposed final rule for the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA), and the American Medical Association (AMA) has pledged its support for its implementation. It represents the most sweeping change in physician payment policy over the last 25 years.

The rule establishes the Merit-based Incentive Payment System (MIPS), which consolidates components of the Physician-Quality Reporting System, the Physician Value-based Payment Modifier, and the Medicare EHR Incentive Program for eligible professionals. This new rule links payments to value via MIPS and measures physicians in quality, cost, technology use, and practice improvement.

In January, acting CMS administrator Andy Slavitt announced 2016 would effectively see the end of the Meaningful Use program, stating the “Meaningful Use program as it has existed, will now be effectively over and replaced with something better,” as Health IT Outcomes reported. CMS later clarified that statement, saying, “The Administration is working on an important transition for the EHR Incentive Program,” but the process will take time. The transition, CMS said, would begin this spring with the release of proposed regulations like the ones just announced for MACRA.

“This proposal, if finalized, would replace the current MU program and reporting would begin January 1, 2017, along with the other components of the Quality Payment Program,” wrote Slavitt and Karen DeSalvo, national coordinator at ONC in a blog post.

The goal of the proposed program, according to Slavitt and DeSalvo, is to create greater physician flexibility and reduce burden. Under the new proposal, providers can opt for payment under MIPS or specific alternative payment models (APMs). Two types of alternative payment models — Advanced APMs and Other-Payment Advanced APMS — are part of the proposed rule. Providers must meet three requirements for each model to be eligible.

Coming in at 962 pages, the proposed rule is scheduled to be published in the Federal Register on May 9. The proposal will be available for public comment for 60 days.