MACRA – Final Rule

Medicare Physician Billing Services for Raleigh, NC & West Palm Beach, FL

Breaking: Medicare finalizes sweeping changes to physician payments

Today, the Centers for Medicare & Medicaid Services (CMS) released the highly-anticipated final rule implementing the Medicare physician payment reforms enacted as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). With the passage of MACRA, Congress set Medicare on a path away from automatic, annual updates hampered by the threat of payment cuts under the flawed sustainable growth rate formula toward a system that focuses more on clinical quality and cost effectiveness. In response to MGMA’s extensive advocacy efforts, the final rule includes greater flexibility for group practices in the Merit-Based Incentive Payment System (MIPS) and more alternative payment model (APM) opportunities.

Key provisions of the final rule:

  • Establishes 2017 as the first performance measurement year for the new Merit-Based Incentive Payment System (MIPS);
  • Reduces the quality reporting burden during first year of MIPS by allowing practices to submit one quality measure or one improvement activity to avoid a penalty or submit data for a reduced reporting period of 90 days to potentially earn a positive payment adjustment; and
  • Details criteria for qualification as an APM participant, including eligibility for bonus payments.

As the Final Rule is reviewed in more detail, we will surely receive more information and guidance to assist with implementation.MACRA


Source: Medical Group Managers Association, Washington Connection, October 14, 2016