MACRA (SGR Fix) Updates

November 2016
Download the webinar: MACRA: What does it mean to you as an allergist /immunologist? (members only)
Answers from MACRA Webinar

August 2016
CMS Announces Easier Reporting for MACRA

The AAAAI and many others asked the Centers for Medicare & Medicaid Services (CMS) to delay implementation of the Medicare Access & CHIP Reauthorization Act (MACRA) to later than the January 1, 2017 start date. CMS responded last week with an announcement that while the start date will be January 1, providers can report for less than the full year and still avoid a penalty. More details will be forthcoming, but the bottom line is that as long as some quality measurement data is reported, penalties can be avoided. There will be several reporting options, including the AAAAI Quality Clinical Data Registry (QCDR), that will allow you to avoid penalties for not reporting and you can earn incentives for more reporting. As further information is made available, it will be posted at aaaai.org/qcdr.

July 21, 2016
AAAAI Responds to MACRA Proposed Rule
Back in April 2015, Congress passed—and President Obama signed into law—the Medicare Access and CHIP Reauthorization Act (MACRA), which replaced the flawed Sustainable Growth Rate (SGR). On April 27 of this year, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule implementing the new MACRA programs, including the Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). After a close review, AAAAI submitted a robust set of formal comments to CMS urging modifications that would enable broader participation by A/I providers in these programs. For your convenience, here is a summary of the main points:
•    AAAAI seeks a delay in the initial performance period, which is slated to begin on January 1, 2017, to give clinicians more time to prepare.
•    AAAAI suggested revisions within each of the MIPS categories, including changes to the available quality measures and additional clinical practice improvement activities.
•    AAAAI expressed concerns with CMS proposals related to the use of certified electronic health record technology (CEHRT), which were supposed to offer eligible clinicians more flexibility and move away from the "all-or-nothing" approach of the EHR Incentive Program.
•    AAAAI also supported CMS emphasis on the use of clinical data registries, such as the AAAAI Qualified Clinical Data Registry (QCDR), which is the only registry that would assist A/I providers with meeting 90% of the reporting requirements under MIPS.

View the AAAAI's formal comments to CMS in their entirety by clicking here.

January 2016
The Future of Health Care Quality in A/I Practice Webinar (Members Only)
If the videos do not open in your browser, make sure you are logged into the website and "right click" on the video link. For Internet Explorer select “Save target as” and for Mozilla Firefox and Chrome select "Save link as" to download the video to your computer. Once the download is complete the video will play in Windows Media Player.

November 2015
AAAAI Responds to CMS Request for Information Regarding MACRA

The Centers for Medicare & Medicaid Services (CMS) issued a Request for Information regarding implementation of the Merit-based Incentive Payment System (MIPS), Promotion of Alternative Payment Models, and Incentive Payments for Participation in Eligible Alternative Payment Models (APMs) to inform the development of regulations and programs for the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. The AAAAI responded with comments, in addition to signing on in support of comments developed by MIPS and APM workgroups convened of specialty societies by the American Medical Association.

AAAAI MACRA Comments Letter
AMA MACRA Comments Letter

May 2015 MACRA follow up
The AAAAI joined the AMA and many other specialties to encourage CMS to work with these societies and other established experts to develop quality measures needed by physicians to participate in new payment models and programs. The AAAAI will continue to update our membership as this important work moves forward. Click here to see the letter.

April 14, 2015
SGR Fix, The “Medicare Access and CHIP Reauthorization Act,” Headed for President’s Signature
On Tuesday, April 14, the Senate passed H.R. 2, the “Medicare Access and Chip Reauthorization Act,” or MACRA by a vote of 92 to 8. The Senate rejected 8 amendments to keep the bill identical to the version passed by the House by a margin of 392 to 37 on March 26. The bill had to be approved by the Senate by April 15 to avoid CMS implementing the SGR 21% cut in reimbursements on Medicare claims for services as of April 1 that would otherwise have gone into effect. Under the provisions of H.R. 2, the fee schedule conversion factor will be increased by 0.5 percent on July 1, 2015, and by another 0.5 percent on January 1, 2016.

The AAAAI partnered with the Hart Health Strategies team to share information with our members, and we know that many of you reached out to your Senators to encourage their support. Now we will continue to work with CMS through the development and implementation of the many program changes required by the law, specifically as it relates to PQRS, Meaningful Use and the Value Based Modifier, all of which will be transformed into a Merit-based Incentive Payment System, to be launched in 2019.

If you had already submitted any Medicare claims for services provided since April 1, 2015, CMS has indicated that you do NOT need to resubmit those claims.

For more information on MACRA, see the links below on this page to analysis provided by the AMA and Hart Health Strategies.

March 23, 2015
As you know, late last week, Congressional leaders released bipartisan legislation to repeal the sustainable growth rate (SGR).  The "SGR Repeal and Medicare Provider Payment Modernization Act of 2015" (H.R. 1470) is similar to legislation passed by the House during the 113th Congress. Here is a table summarizing key differences between the two versions. Please keep in mind that multiple provisions expected to be included in H.R. 1470 have yet to be released, although we expect to see this additional language before the end of the week. 

SGR Repeal—Act Now!
It’s time to fix Medicare once and for all! The 17th temporary patch is set to expire on March 31. Now is the time to contact your local Representative and Senator to address the Sustainable Growth Rate (SGR). The AAAAI continues to work closely with Hart Health Strategies on this very important issue. In fact, earlier this week the AAAAI signed onto a letter to Speaker Boehner urging the repeal of the failed SGR before the current payment patch expires.

November 2014
The AAAAI is on the record supporting the “SGR Repeal and Medicare Provider Payment Modernization Act of 2014,” which permanently repeals the SGR while addressing many physician concerns: providing a five-year period of stable updates, preserving fee-for-service as a continued option, implementing a streamlined quality improvement program based on benchmarks achievable by all physicians, allowing for physician and specialty society inclusion in the development of new performance measures and payment systems.

We recently signed onto a letter to Congressional leaders asking the lame duck Congress to pass this SGR bill and the “Ensuring Access to Primary Care for Women & Children Act,” which would extend Medicaid Primary Care Pay Parity by two years. As Congress completes its work during the lame duck session this month, Hart Health has put together a memo regarding fixing the SGR. Find both documents below.

March 11, 2014
In mid-March, the AAAAI wrote to House and Senate Committee leaders to support legislation that would permanently repeal the Sustainable Growth Rate (SGR), the formula used by the Centers for Medicare and Medicaid Services to control spending for physician services provided to Medicare beneficiaries. Read the full letter here.

The bill under consideration in March included a number of important physician payment reform provisions including a report on barriers to chronic care services and a provision to increase the availability of Medicare claims data for research to improve the quality of care. However, lawmakers were unable to agree on a source of reductions elsewhere in the budget to pay for the estimated $138 billion cost of the SGR repeal. Instead of a permanent repeal, Congress staved off the 24% reduction that would have occurred on April 1 with another temporary “fix” bill to prevent the cuts. The bill also includes a 0.5% increase in payments to physicians through December 31, 2014, and then freezes reimbursement levels for the first quarter of 2015.  

The fundamental position of the AAAAI on this issue is that Medicare payments to physicians should be based on quality and value, not an arbitrary volume-based system. Unfortunately, now that Congress has passed another 12-month delay of the scheduled cuts, little action is expected on this issue until next year.

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