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CMS Offers 4 Options for First Year MACRA Compliance

UPDATE: In response to CMS Acting Administrator Andy Slavitt’s Sept. 8 announcement that the agency would not delay MACRA implementation, leaders of the U.S. House Energy and Commerce Committee and Ways and Means Committee issued a statement Sept. 9 indicating that they were pleased that CMS was moving forward with options for compliance with the law.

“We’re pleased to see the Administration is including our recommendations in its implementation of MACRA,” said Energy and Commerce Committee Chairman Fred Upton (R-MI), Ranking Member Frank Pallone, Jr. (D-NJ), House Ways and Means Committee Chairman Kevin Brady (R-TX) and Ranking Member Sander Levin (D-MI). “By providing flexibility for doctors and other health care providers, we are helping ensure this historic law delivers the quality, value-based care Medicare beneficiaries deserve. We’re committed to continuing our work with each other, stakeholders, and the Administration so that doctors can prioritize patient care instead of focusing on burdensome paperwork.”


With the deadline looming for implementing the Medicare Access and CHIP Reauthorization Act (MACRA), the Centers for Medicare and Medicaid Services (CMS) is offering physicians four options for first year compliance with the program that would not result in a negative payment adjustment, Andy Slavitt, Acting CMS Administrator, announced Sept. 9.

CMS stated that it plans to release the final rule for MACRA by Nov. 1. “But, with the Quality Payment Program set to begin on January 1, 2017, we wanted to share our plans for the timing of reporting for the first year of the program,” Slavitt stated.

Further, CMS indicated that with the “wide diversity of physician practices,” it wanted to allow them to pick their pace for the first performance period beginning Jan. 1, 2017. Therefore, the agency is offering four options for MACRA compliance during the first year, and plans to provide additional detail regarding these option in the final rule.

Option 1: Test the Quality Payment Program. Under this option, as long as physicians submit some data to the Quality Payment Program, including information from after Jan. 1, 2017, then they will avoid a negative payment adjustment. This will allow providers to make sure their systems are working and help them prepare for wider participation in subsequent years, Slavitt said.

Option 2: Participate for Part of 2017. Practitioners may choose to submit data to the Quality Payment Program for a reduced number of days in 2017, allowing them to begin their first performance period later than Jan. 1, 2017. These practices could also qualify for a small positive payment adjustment, according to CMS. “For example, if you submit information for part of the calendar year for quality measures, how your practice uses technology, and what improvement activities your practice is undertaking, you could qualify for a small positive payment adjustment,” Slavitt offered.

Option 3: Participate for Full Calendar Year. If providers are ready to start on Jan. 1, 2017, then they can choose to submit Quality Payment Program data for a full calendar year, meaning their first performance period would begin on Jan. 1. “We've seen physician practices of all sizes successfully submit a full year’s quality data, and expect many will be ready to do so,” Slavitt stated.

Option 4: Participate in an APM. If a practitioner receives enough Medicare payments or sees enough Medicare patients through an Advanced Alternative Payment Model (APM) in 2017, then they will qualify for a 5 percent incentive payment.

Regardless of the option practices choose, CMS plans to offer resources to ensure they have the necessary support with program reporting. “And however you choose to participate, your feedback will be invaluable to building this program for the long term to achieve outcomes that matter to your patients,” Slavitt said.