Medical Billing Lytec

Comments On MACRA

CMS invited comments on the proposed Medicare Access and CHIP Reauthorization Act (MACRA) last month, and received hundreds and thousands of remarks on the same. Most noted comment, however, came from the American Medical Association (AMA), who believe that the Medicare payment reform programs should be modified a bit. The agency is concerned that though the proposed act improves the current value-based programs, but the same would be a major undertaking for many healthcare providers

“Throughout the years-long process of fighting to eliminate the deeply-flawed SGR, the AMA heard clearly from physicians that they want a new incentive system that reduces red tape, fosters flexibility and innovation in the delivery of care, and establishes a direct link between payments and quality of patient care,” AMA President Andrew W. Gurman, said in their letter to CMS.

“While we believe CMS is expressing responsiveness to physician concerns in implementing the new law, we urge Acting Administrator Slavitt and his staff to make changes to the program rules to ensure physician and patient needs are met,” he added. The letter also suggested a few alternatives to adopt, which would ensure a smoother transition. In addition to that, AMA insisted on delaying the implementation date from Jan 1 to July 1, 2017.

Medical Billing Outsourcing

MACRA Implementation

AMA suggests that the first year should be considered as a transitional period, allowing healthcare providers to learn about the new reforms thoroughly. They can then come up with the required changes for a smooth move from the existing Medicare reporting system to the new one. The suggested 6-month extension would also let health IT vendors update their current systems as per the MACRA requisites. In the meantime, CMS would also be able to modify the present APMs to make them qualify for MIPS.

“The AMA strongly urges CMS to work to establish a more holistic approach and not maintain the divide between different MIPS categories,” the letter added. “A holistic approach would transform MIPS from a continuation of four distinct compliance programs to one in which physicians can identify a purpose to the reporting activities.”

“CMS needs to develop a pathway and provide assistance to organizations that wish to develop and/or become participants in MACRA APMs. There also needs to be a pathway to help MIPS APMs transition to become Advanced APMs,” Gurman wrote. AMA hopes that the comments would bring potential issues to light and CMS would come up with apt plans to counteract them.