MACRA Nov 2016 Update

MACRAMACRA stands for the Medicare Access and CHIP Re-authorization Act and is the new system that the Center for Medicare and Medicaid Services (CMS) will be using as of January 2017. As with anything new there are facts, updates and rumors so let’s briefly clear out the rumors. Rumor: MACRA implementation will be delayed. Fact: Implementation will not be delayed but Providers will have some flexibility in terms of level of participation during the 2017 calendar year.   Rumor: President elect Trump will override/eliminate MACRA. Fact: MACRA was passed as a full bipartisan effort so there are no indications that this particular change will be part of President Elect Trump’s agenda.   The changes we have been privy of as of the date of this publication are as follows: Provider options:

  • report under MIPS for 90 days;
  • report under MIPS for less than a year but more than 90 days and report more than one quality measure, more than one improvement activity, or more than the required measures in the advancing care information performance category;
  • report one measure in each MIPS category (besides resource use which is automatically reported) for the entire year; or
  • participate in an Advanced APM.

Do keep in mind that if Providers that fail to report on at least one measure or activity will receive the full 4 percent negative adjustment in their Medicare payments. Exceptions:

  • Physicians and/or related professionals that see less than 100 Medicare patients per year
  • Physicians and/or related professionals that total Medicare Part B accounts receivable is less than 30,000 per year.

There are more details regarding the final rule but for now simply remember that MACRA is not going anywhere.