ASCRS/ASOA Creates Online Medicare Physician Payment Reform Resource Center to Assist Members in Understanding Provisions of the Recently Enacted Medicare Access and CHIP Reauthorization Act (MACRA)

This week, ASCRS•ASOA created a new webpage designed to assist members in understanding and complying with provisions enacted as part of MACRA. The Medicare Physician Payment Reform Resource Center includes a summary of MACRA, FAQs, Myths and Facts, ASCRS Issue Briefs, and a comparison with pre-existing law.

As a reminder, MACRA was enacted April 16, 2015 and repealed the flawed Sustainable Growth Rate (SGR). MACRA replaces the SGR with five years of positive 0.5% updates and implements a new program, the Merit-Based Incentive Payment System (MIPS). MIPS consolidates the existing quality reporting programs—PQRS, EHR/Meaningful Use and the Value-Based Payment Modifier—and adds an additional section on clinical practice improvement activities. Penalties associated with the programs will sunset beginning in 2019. Under the new MIPS program, physicians remaining in the fee-for-service program will receive a composite score based on their performance and will receive a bonus payment, no payment adjustment, or penalty depending on pre-set performance thresholds. In addition, MACRA prevented CMS from implementing its policy to transition all 10- and 90-day global codes to 0-day codes, which would have decreased payments to ophthalmology more than any other specialty. Visit the Resource Center for additional details.

It is important to remember, however, complete details of the MIPS program will be developed over the coming years through the rulemaking process. ASCRS•ASOA will continue to monitor those developments and provide you with information when it is released. While the MIPS program reflects ASCRS•ASOA and the medical community’s advocacy to streamline and make current quality reporting programs more flexible, physician participation in the program will still be significant and require continued advocacy to ensure the program recognizes the need for meaningful quality measures for specialists. In addition, there is nothing to preclude further legislation in the future, should more reforms be necessary. ASCRS•ASOA will also continue to advocate for higher updates in the future, since it will be less expensive to increase payments from the positive baseline MACRA provides, rather than preventing the significant cuts that were threatened from the SGR. We will continue to provide updates in Washington Watch Weekly and on our website.

Also this week, ASCRS signed onto a letter from several surgical and specialty organizations thanking Congressional leadership for enacting MACRA, and specifically for including the provision to prevent CMS from eliminating 10- and 90-day global codes.