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March 29, 2016



Price, Scott Introduce CJR Delay Legislation

Bonefied News

Energy and Commerce Discusses MACRA Implementation

Ensuring Access for Athletes During #MarchMadness

House Oversight Debates HIT

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Energy and Commerce Discusses MACRA Implementation

On March 17, 2016, the Energy and Commerce Subcommittee on Health, chaired by Rep. Joseph Pitts (R-PA), held a hearing examining the implementation of Medicare payment reforms. The hearing focused on the repeal of the Sustainable Growth Rate (SGR) formula and the bipartisan and bicameral agreement that replaced the SGR: the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA passed the House of Representatives on March 26, 2015, by a vote of 392-37 and the Senate on April 14, 2015, by a vote of 92-8. The President signed MACRA into law on April 16, 2015 (read more in Advocacy Now).

Pitts highlighted the “historic” legislation in his opening remarks, commenting that members of Congress have “worked over many years to address the problems associated with the SGR and impending yearly payment cuts to doctors that inevitably were avoided thanks to short-term, temporary patches – 17 in all.”

“Many were interested in finding a solution, but not until the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was enacted – with overwhelming bipartisan support in the House and Senate – did we finally achieve reforms for physician payments while also promoting high quality care for patients,” Pitts continued. “Through a variety of incentives, physicians are encouraged to engage in activities to improve quality. Existing quality reporting programs are consolidated and streamlined into a new Merit-based Incentive Payment System (MIPS).”

Pitts also highlighted the “strong incentives” created for physicians to participate in qualified Alternative Payment Models (APMs), specifically pointing to Patient Centered Medical Homes. Additionally, he emphasized the technical support that will be provided for smaller practices and the funding that is provided for quality measure development, adding that “physicians will retain their role in developing quality standards.”

Subcommittee members had the opportunity to check-in with the Centers for Medicare and Medicaid Services (CMS) about how the implementation process is going, and to discuss the work the agency is doing to encourage value based payments that would qualify as an eligible alternative model. Deputy Administrator for Innovation and Quality and CMS Chief Medical Officer Patrick Conway, MD, who testified on behalf of CMS, noted that successfully transforming the health care system depends upon a critical mass of partners adopting new models.

“It is vital to engage partners who are also committed to, and have a stake in, improving our health care system, including patients, providers, payers, government, and businesses,” Conway stated. “We know physicians and other clinicians have a lot of demands on their time, and we are grateful for the robust response from the stakeholder community to these requests for feedback. We are currently in the process of reviewing and incorporating the feedback we received, and we anticipate releasing a proposed MACRA implementation rule, including a 60-day comment period, this spring. We look forward to continued engagement from Congress and the health care community.”

Conway also reiterated the agency’s desire to build flexibility into meaningful use with the forthcoming program, noting that the statute gives CMS “flexibility to really focus on interoperability, outcomes for patients, simplifying the program and making it as meaningful as possible to physicians, clinicians and the patients they serve.” Rep. Marsha Blackburn and Rep. Gene Green echoed the need for meaningful use reform. Blackburn noted that meaningful use has become meaningless, and interoperability is essential for MACRA’s payment models to succeed. Green added that the “importance of getting to interoperability has never been greater.”

Read AAOS’s response to CMS’s request for information online here.

Additional information on the hearing, including a background memo, witness testimony and an archived video can be found on the Energy and Commerce website here.

Find more information on MACRA, including APMs and the MIPS program on the AAOS website at