The proposed rule aims to simplify reporting requirements and offer support for doctors and clinicians in 2018.
This article was originally published in Post-Acute Advisor.
On Tuesday, June 20, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would make changes in the second year of the Quality Payment Program as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The agency states that their goal is to simplify the program, especially for small, independent, and rural practices, while ensuring fiscal sustainability and high-quality care within Medicare.
Changes outlined in the proposed rule are intended to encouraging doctor and clinician participation in either Advanced Alternative Payment Models (APMs) or the Merit-based Incentive Payment System (MIPS) by amending some existing requirements and adding new policies for those participating in the program. Physicians who do not participate in either model face penalties, as outlined by MACRA.
CMS reports that the Quality Payment Program, which is updated annually as part of MACRA, is meant to promote greater value within the healthcare system. Clinicians can choose how they want to participate in the Quality Payment Program based on their practice size, specialty, location, or patient population.
“We’ve heard the concerns that too many quality programs, technology requirements, and measures get between the doctor and the patient,” said CMS Administrator Seema Verma. “That’s why we’re taking a hard look at reducing burdens. By proposing this rule, we aim to improve Medicare by helping doctors and clinicians concentrate on caring for their patients rather than filling out paperwork.”
Additional updates in the proposed rule include increasing the number of small providers that are exempt from having to comply with MACRA. For example, physician practices with less than $90,000 in Medicare revenue or fewer than 200 unique Medicare patients per year would be exempt from the program.
CMS also reports that they are making it easier for rural and small providers to participate by offering “virtual groups” that gives these providers the opportunity to partner together in order to reach compliance. Little interest has been shown for this option, however.
A fact sheet on the proposed rule can be found here. Comments are due no later than 5 p.m. ET on August 21. Commenters should reference file code CMS 5522-P.
Brianna Shipley is on HCPro’s Long-Term Care Team. It focuses on delivering information, education, and guidance on complex topics such as MDS and care planning to help long-term care administrators and managers, reimbursement professionals, and clinical staff members break down confusing regulations into easy-to-understand processes and procedures.