CMS Changes MACRA Regulations Based on Physicians’ Concerns

Last April, the Centers for Medicare & Medicaid Services (CMS) issued a draft regulation proposing a requirement for physicians to begin reporting under the Merit-based Incentive Payment System (MIPS) or through the advanced alternative payment model (APM) option on Jan. 1, 2017 under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), even though the final regulations for the payment system changes wouldn’t be issued until this fall.

Following news of the draft proposal, physician organizations had voiced their concerns about the proposed start date. In a recent blog posting, Andrew Slavitt, Acting Administrator for CMS, acknowledged the physicians’ concerns and stated that based on the feedback they received, CMS has decided that the final MACRA regulation will exempt physicians from any risk of penalties if they choose one of three distinct MIPS reporting options in 2017, along with the option of participating in an advanced APM:  

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

Among the physicians who report in 2017, and depending on which option they choose, they may be eligible for bonus payments in 2019. Those who opt for full-year reporting will be eligible to receive a modest positive payment adjustment, and those who choose partial year reporting will be eligible for a small positive payment adjustment, according to CMS. Physicians who choose the “test” option will not be subject to any payment adjustments. Qualified participants in advanced APMs will be eligible for 5% incentive payments in 2019.

The American Medical Association (AMA) praised Slavitt and Department of Health & Human Services Secretary Sylvia Burwell for listening to physicians and providing the necessary flexibility to launch a successful payment system under MACRA. To read the AMA’s short statement, click here.  

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