2017-10-13 14:02:51 UTC

AGA and House of Medicine Call on Congress to Provide MACRA Flexibility

Oct. 13, 2017

GIs need flexibility to successfully participate in the MIPS program.

AGA believes that continued flexibility is needed in the Merit-based Incentive Payment System (MIPS), one of the paths in the Quality Payment Program under MACRA (Medicare Access and CHIP Reauthorization Act).
AGA joined organized medicine in calling on Congress to address the following issues to ensure that physicians are prepared and ready to successfully participate in MIPS, and that Centers for Medicare & Medicaid Services (CMS) has the flexibility needed for successful implementation:
  1. Cost Category Weight. Provide the Health and Human Services (HHS) secretary the flexibility to set the cost category of MIPS at a lower rate than the 30 percent required by law by 2019. CMS set the rate at 0 percent in 2017 and has proposed to set it at 0 percent in 2018. We ask Congress to give HHS flexibility to set the rate lower than 30 percent, but no more than 10 percent through the 2021 performance year. This will allow CMS the time to properly calculate the cost measures, which are set to be pilot tested among various specialties for various conditions. AGA and the GI community are working with CMS on the screening and surveillance colonoscopy episode, which has yet to be tested in practice. This flexibility is necessary to ensure these cost measures are accurate.
  2. Performance Threshold. Provide the HHS secretary the flexibility to continue to set the MIPS performance threshold at a level commensurate with clinician readiness, rather than the mean or the medium performance level that is required under law. Similar to the cost category, we ask Congress to give CMS the flexibility through 2021.
  3. Application of MIPS to Part B Drugs. Clarify that MIPS payment adjustments should only apply to covered professional services, and not include the cost of physician-administered drugs, which could provide perverse incentives that were not intended by Congress.        
  4. Definition of small practice. Clarify that the definition of small practice only includes MIPS eligible clinicians and not other allied health professionals who could prevent a practice as qualifying as a small practice.
AGA Advocates for You
AGA and the entire house of medicine sent a letter organized by American Medical Association (AMA) to Congress asking for continued flexibility in MIPS.  
In coordination with the Alliance of Specialty Medicine, AGA sent a similar letter to Congress calling for increased flexibility in MIPS to ensure that physicians are able to comply and be successful in the new Medicare payment system. Additionally, we have been meeting with congressional offices on this issue to reiterate the importance of implementing these changes to ensure that clinicians will be successful in the MIPS program. We will continue to advocate for these changes and work to include them into Medicare technical corrections legislation before the end of the year.  

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