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Tags Posts tagged with "Medicare Access and CHIP Reauthorization Act"

Medicare Access and CHIP Reauthorization Act

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The United States Senate Committee on Finance will conduct a full committee hearing (Medicare Physician Payment Reform After Two Years: Examining MACRA Implementation and the Road Ahead) on Wednesday, May 8, 2019 at 10:15 am. The purpose of the hearing will be to assess if the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 has been successful in reforming physician payments. Witnesses scheduled to present information during the hearing include individuals from: American Medical Association, American Academy of Family Physicians, American College of Surgeons, American Medical Group Association, and Brookings Institution.

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The Energy and Commerce (E&C) Health Subcommittee has scheduled a hearing for Thursday, July 26, 2018 at 10:00 am. The hearing is entitled MACRA and MIPS: An Update on the Merit-based Incentive Payment System. This will be the fourth oversight hearing on the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. Members of the Subcommittee will hear from witnesses on the importance of fee-for-service as an option for certain physicians in the traditional Medicare and how the Merit-based Incentive Payment System (MIPS) has acted as a way to streamline quality programs, provided new financial opportunities for providers to participate and transition to new models of care. The witness list and testimony for the hearing will be posted to the E&C website as they are received. The hearing webcast will also be available. Contact Melissa Dehoff, RCPA Director of Rehabilitation Services, with any questions.

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During the January 2018 Medicare Payment Advisory Commission (MedPAC) public meeting, the agenda included the topic of the Merit-based Incentive Payment System (MIPS). MedPAC members voted in favor of recommending Congress eliminate this system, stating the program was burdensome and complex. The presentation also cited that the program “Replicates flaws of prior value-based purchasing programs.” It was recommended that MIPS be replaced with a new model known as the voluntary value program (VVP). The VVP would include an across-the-board withhold for all fee schedule payments, and performance would be assessed using uniform measures across three categories, which include clinical quality, patient experience, and value. Those in favor of the new program indicated it would better prepare physicians to participate in the Medicare Access and CHIP Reauthorization Act’s (MACRA) Advanced Alternative Payment models.

The agenda included many additional topics of interest, some of which referenced increasing the equity of Medicare’s payments within each setting, mandated report on telehealth services and the Medicare program, and a status report on Medicare Accountable Care Organizations.

The Energy & Commerce House Health Subcommittee scheduled a hearing for Wednesday, November 8, 2017, at 10:00 am in room 2123 of the Rayburn House Office Building. The hearing will focus on the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 and Alternative Payment Models: Developing Options for Value-based Care.

Members of the subcommittee will discuss alternative payment models (APMs) and hear from those that are already engaged in the transition to value-based care, as well as those developing new models and stakeholders who are already delivering improved outcomes and savings for Medicare beneficiaries and taxpayers.

The Majority Memorandum, witness list, and witness testimony for the hearing will be available here as they are posted.

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On November 4, 2016, the Centers for Medicare and Medicaid Services (CMS) published the final rule with comment period for the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as the payment program that will replace the Sustainable Growth Rate methodology. The rule finalizes MACRA’s Quality Payment Program, whose primary goal is to reduce administrative burden on physicians to allow them to focus on improving care, promote the adoption of value-based care, and smooth the transition to these new models of care. The final rule establishes guidelines for Medicare health care providers to participate in either the Advanced Alternative Payment Models (APMs) or the Merit-based Incentive Payment System (MIPS), which consolidates components of three existing programs: the Physician Quality Reporting System, the Physician Value-based Payment Modifier, and the Medicare Electronic Health Record (EHR) Incentive Program for Eligible Professionals. According to CMS, the Advanced APMs pathway provides clinicians with the opportunity to be paid more for better care and investments that support patients by reducing existing requirements, while still emphasizing and rewarding quality care. Participants in the advanced APMs must meet the following requirements:

  • Be part of CMS Innovation Center models, Shared Savings Program tracks, or certain federal demonstration programs;
  • Use certified EHR technology;
  • Base payments for services on quality measures comparable to those in MIPS; and
  • Be a medical home model expanded under innovation center authority or require participants to bear more than nominal financial risk for losses.

The final rule has a 60-day comment period, with comments due by Monday, December 19, 2016. RCPA will be offering a webinar in the near future on the details of the final rule, hosted by the American Medical Rehabilitation Providers Association (AMRPA). The date and time will be released soon.