Medicare & Medicaid

CMS finalizes historic Medicare reform law

By
Troy Parks News Writer
| 2 Min Read

A final rule released today by the Centers for Medicare and Medicaid Services (CMS) details the final regulations for implementation of the Medicare Access and CHIP Reauthorization Act (MACRA), the historic Medicare reform law that repealed the Sustainable Growth Rate (SGR) formula last year.

The AMA will now pore over and dissect the final regulations in the coming days to make sure you know exactly what the rule contains and how it will impact your practice.

What we know already

CMS made some significant changes in the proposed rule issued last spring, demonstrating that they took physician input into consideration, announcing changes that will help physicians make the transition, including:

  • Pick your pace: CMS announced in September that the final regulation will exempt physicians from any risk of penalties if they choose one of four participation options in 2017. The takeaway—even minimal performance reporting will exempt you from any penalties, and opportunities for a shorter, 90-day reporting period will make you eligible for positive payment adjustments.
  • Low-volume threshold exemption: Practices with less than $30,000 in Medicare payments or fewer than 100 Medicare patients will be exempted from performance reporting entirely.
  • Resource use holds 0 percent weight in year one: The Merit-based Incentive Payment System (MIPS) has four components, one of which is resource use. In the first year of implementation, this category will hold 0 percent weight toward your MIPS score.

What to do right now

Take advantage of the resources and educational materials on the AMA’s Understanding Medicare Reform Web page.

  • The AMA Payment Model Evaluator can help you determine the impact the final regulations will have on your practice and will be updated continually to reflect what is in the rule.

Several modules are available from the AMA’s STEPS Forward™ collection of practice improvement strategies that can help your practice:

The AMA will host educational events in the next few months to help physicians understand what the regulations mean for the future of their practice, which will be accessible both in-person and online. Details and registration will be available soon.

Watch AMA Wire® in the coming weeks for a more detailed look at what CMS included or changed in the final regulations as experts decipher their impact on practices that serve patients under Medicare.

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