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CMS announces more options for MACRA compliance

The Centers for Medicare and Medicaid Services (CMS) announced yesterday plans to help ease implementation of the new Quality Payment Program by allowing more flexible data reporting options. The new payment model was created by the 2015 Medicare Access and CHIP Reauthorization Act (MACRA), and goes into effect January 1.

“In recognition of the wide diversity of physician practices, we intend for the Quality Payment Program to allow physicians to pick their pace of participation for the first performance period that begins January 1, 2017,” said CMS Acting Administrator Andrew Slavitt in this blog post. “During 2017, eligible physicians and other clinicians will have multiple options for participation.”

Slavitt said choosing one of the four options will ensure physicians do not receive a negative payment adjustment in 2019.

Each option will be described fully in the final rule, which will be published before November 1. Physicians may participate in an Alternative Payment Model, although most are expected to choose one of three distinct Merit-Based Incentive Payment System (MIPS) options instead:

  • Full-year reporting that begins on January 1.
  • Partial year reporting for a reduced number of days that may begin after January 1.
  • A “test” option under which physicians can report minimal amounts of data.

“This is certainly good news for our members, especially those physicians practicing individually or in small groups. CMS is listening,” said Society CEO Rick Abrams. “Our advocacy work is far from over, however. The goal is to create a medical practice and care delivery environment where everyone succeeds so that we maintain—in fact enhance—the joy of practice for our physicians. By doing so, there is no question that Wisconsin will continue to be a state where people receive the highest quality, most cost efficient care anywhere.”

Slavitt’s announcement came following tremendous feedback from the Society, American Medical Association and numerous other physician organizations and individuals. In its comments, the Society expressed concern about the program’s aggressive timeline, among other concerns.

“Under the proposed rule, 60 days after the final rule is published, physicians would begin to be rated/report on their performance with no testing to ensure their ability to participate and with no assurance that CMS has the capability to validate accuracy of scores or ratings within each compartment of the MIPS compartment score,” said Abrams in the comments.

“The Society has several concerns regarding the implementation timeline, including the short lead time for physicians to learn the rules and the inadequate time to make practice adjustments. Simply put, the implementation timeline needs to be adjusted! The Society has had a longstanding position that movement toward a new payment system should be preceded by a period of payment stability for physicians and their practices. CMS should work to preserve a period of stability during its implementation of MACRA by providing for a period of transition and testing in the first three to six months of 2017,” Abrams continued. “This stable transition period should include assurances that CMS has conducted appropriate testing, including physicians’ ability to participate and validation and accuracy of scores or ratings, and that CMS has the necessary resources to implement provisions regarding MIPS and APMs.”

More information about MACRA implementation also is included in this June 23 Medigram story.