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April 27, 2016

CMS Releases MACRA Proposed Rule

Washington, DC—Today, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule detailing for the first time the physician reimbursement framework required by the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. The American Association of Orthopaedic Surgeons (AAOS) has previously communicated with CMS on the implementation of select provisions of MACRA, including episode groups, aspects of the Merit-Based Incentive Payment System (MIPS), developing alternative payment models (APMs), and encouraging creation of physician-focused payment models. AAOS leadership and staff are closely reviewing today’s proposed rule and will be providing CMS with detailed comments.

“The importance of this proposed rule cannot be overstated,” said AAOS President Gerald R. Williams, Jr., MD. “This is a significant and complex regulation that alters physician reimbursement and implements a number of new initiatives to decrease cost and improve quality of care for Medicare beneficiaries. Physician involvement in the development and implementation of MACRA is critical. As specialty physicians, orthopaedic surgeons face unique challenges and require specialty-specific tools, measures, and other considerations in order to successfully participate in quality performance programs and APMs. We look forward to working closely with CMS to refine MACRA provisions and ensure physician payment reform ultimately improves the care of musculoskeletal patients.”

UPDATE 4/29/16: “AAOS recognizes CMS’ efforts to provide additional flexibility and respond to specialty-specific concerns, especially in areas of quality reporting,” stated Thomas C. Barber, MD, Chair of the AAOS Council on Advocacy. “The removal of an ‘all-or-nothing’ approach and the decreased number of measures are significant positive changes from current policy. However, there are a number of issues that still need to be addressed. Specifically, AAOS has concerns about the timing of implementation and infrastructure readiness, the restrictive requirements for Advanced APMs, and access to Medicare claims data. AAOS will be coordinating formal written comments with state and specialty societies and looks forward to working closely with CMS to address these concerns.”

For further information, visit or read previous comments to CMS:
  Read the proposed rule online:
CMS fact sheet: 
HHS press release:

Follow the AAOS Office of Government Relations on Twitter: @AAOSAdvocacy
Elizabeth Fassbender
Communications Manager
AAOS Office of Government Relations
(202) 548-4143
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