Washington, DC—Yesterday, the Centers for Medicare & Medicaid Services (CMS) announced new flexibility in the implementation of Medicare’s Quality Payment Program, which was required by the Medicare Access and CHIP Reauthorization Act (MACRA) and replaces the Sustainable Growth Rate (SGR) formula. In a CMS blog post, Acting Administrator Andy Slavitt laid out four options for reporting data under the Quality Payment Program.
First Option: Test the Quality Payment Program. According to CMS, with this option, as long as physicians submit “some data,” including data from after January 1, 2017, physicians will avoid a negative payment adjustment.
Second Option: Participate for part of the calendar year. Physicians may choose to submit Quality Payment Program information for a reduced number of days, allowing the first performance period to begin later than January 1, 2017 while still qualifying physicians for a small positive payment adjustment.
Third Option: Participate for the full calendar year. For practices that are ready to go on January 1, 2017 and submit Quality Payment Program information for a full calendar year, physicians could qualify for a modest positive payment adjustment.
Fourth Option: Participate in an Advanced Alternative Payment Model in 2017.
This announcement comes after intense pressure from numerous physician groups – including the American Association of Orthopaedic Surgeons (AAOS) – that urged for greater flexibility in the implementation timeline. In its comment letter to CMS, AAOS explained that it would be “burdensome, if not impossible, for physicians to get ready for the first performance year of 2017” and that “physicians who find this time frame too difficult to comply with may not participate in the MIPS program at all.” Therefore, AAOS thanks Secretary Burwell and Acting Administrator Slavitt for their work to address these concerns. Still, there are additional issues that must be addressed to ensure smooth MACRA implementation and AAOS looks forward to examining the final rule this fall.