2016-06-28 18:50:52 UTC

June 28, 2016

We’ve asked CMS for dozens of changes that are needed to make MACRA work for GIs without limiting patients’ access to crucial specialty care.

AGA provided comments on the landmark Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 proposed rule, created by CMS. MACRA will substantially impact the way you are reimbursed for providing care to Medicare patients. Once finalized, the rule will become effective on Jan. 1, 2017, and will impact your payments beginning in 2019.  

While MACRA was intended to lessen the burden for physicians caring for patients, CMS proposed rules that make the burdens worse in many areas. AGA’s comments to CMS asked for dozens of changes that are needed to make MACRA work for gastroenterologists without limiting patients’ access to crucial specialty care.

In addition to these specific recommendations, AGA’s comment letter stressed:

  • Congress enacted MACRA to provide stability in physician payments and eliminate unnecessary red tape that limits the ability of physicians to provide patient care. New requirements should avoid the rigid, unresponsive programs currently in place, because Congress did not intend to replace one inflexible payment system with another. The quality payment program (QPP) should serve as a tool for physicians to replace complex administrative burdens with greater focus on patient care and outcomes. In administering the QPP, CMS should move beyond the rigid standards that were part of physician quality reporting system, value-based payment modifier and meaningful use. 
  • AGA asked CMS to ensure that the views of gastroenterologists are taken into consideration when adopting rules for the QPP. Physicians have the greatest expertise and insight into the hurdles facing medical practices. The medical community is also the most reliable source of how burdensome new requirements will impact patients. New requirements should be flexible, as well as reactive, to physician and patient concerns.
  • New alternative payment models, which provide lump sum incentive payments for qualifying practices and physicians, should be reflective of the many innovative efforts from gastroenterologists. AGA members made great strides in recent years to develop new ways of delivering and paying for GI services in a way that balances the primary goal of patient care with the need to identify new ways of encouraging communication across practice settings and providers. The substantial benefits for APM participants must be available to specialty physicians, because of their important role in managing care for Medicare patients. 

The GI’s Guide to MACRA
In order to help you adapt to the new rules, AGA has developed a series of resources to provide you with comprehensive information on what MACRA is and how you can best position your practice to succeed once the QPP is implemented. Throughout the year, we will continue to roll out new materials to help you thrive in the post-MACRA world. 

CMS is expected to release the MACRA final rule in the fall and the requirements will take effect in 2017. AGA members will be notified as soon as the rule is made available by CMS. 

More on MACRA