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CMS Announces Flexibility on MACRA Requirements

Posted in Accountable Care Organizations, Affordable Care Act, Legislation and Public Policy, Medicare and Medicaid, Reimbursement Matters

With Congress having joined the increasing pressure from physicians concerning the proposed timeline for implementing Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) rules, the Centers for Medicare & Medicaid Services (CMS) announced that it will allow providers to choose the level and pace at which they comply with the new payment reform model, at least for 2017.

In a September 8 post on the CMS Blog, Andy Slavitt, Acting Administrator of CMS, said, “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.” Physicians will be able to choose one of the following four options to comply with the new payment rule:

  • Test the Quality Payment Program by submitting some data and avoid a negative payment adjustment
  • Participate for part of the year by submitting data for a reduced number of days and still qualify for a small quality payment if the data provides evidence on how the practice is using technology and how it’s improving
  • Submit a full year of quality data and participate in the Merit-Based Incentive Payment System as originally published
  • Participate in an advanced alternative payment model such as a Medicare Shared Savings ACO

The payment reform provisions of MACRA are intended to replace the widely reviled Medicare Sustainable Growth Rate formula and merge several existing reporting programs under one umbrella. CMS expects to publish the final rule in November.

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