CMS Announces Flexible Options for Participation in MACRA Payment Systems

By Policy and Advocacy Brief posted 09-08-2016 20:02


Earlier today, Centers for Medicare & Medicaid Services (CMS) Acting Administrator Andrew Slavitt announced a new plan to provide physicians flexible options for complying with new payment systems as outlined by the Medicare Access & Chip Reauthorization Act (MACRA). Implementation of this critical piece of regulation is slated to begin in 2017. 

The AUA is one of many leading healthcare organizations that has been working with CMS to provide much-needed input into the regulations. The agency has solicited input from key stakeholders on multiple occasions as it worked to develop the regulations. In November 2015, we responded to a request for information to aid CMS as it began to prepare the regulation, and earlier this summer, we provided comments on the much-anticipated proposed rule for MACRA/MIPS. Like many groups, the AUA has shared concerns about the proposed regulations and implementation timelines. In July, AUA physicians also spent half a day on Capitol Hill in July advancing sound health care policy by asking for congressional support for modifying the start date of MACRA/MIPS so physicians and practices have adequate time to prepare for the new program.

Under the new plan announced by CMS, physicians will have four options to comply with the alternative payment models as outlined by MACRA (MIPS and alternative payment models, or APMs). These options include:

    • Full-year reporting, starting January 1, 2017
    • Partial year reporting
    • A “test” option that allows physicians to report a minimal amount of data
    • Participation in an advanced APM.

Under the first two options, participating physicians will be eligible for “modest positive payment adjustments” and those who opt for the “test” option will not be subject to penalties or increases. Those who participate in an APM will be eligible for incentive payments as outlined by MACRA starting in 2019.

“For more than a decade, the AUA has been advocating with lawmakers and regulators to ensure that payment reform is fair and that physicians are paid appropriately for the work they do each day,” said AUA Legislative Affairs Committee Chair Dr. Jim Ulchaker. “We applaud CMS for its commitment to working with physicians to develop these important regulations.”

“We are pleased that our advocacy efforts on the Hill were fruitful and that CMS has considered the magnitude of the burden that immediate implementation of MACRA would have been,” said Dr. Thomas Rechtschaffen, AUA Gallagher Health Policy Scholar, who was among the specialty physicians who visited the Hill in July. “The increased flexibility offered by CMS will allow small and large practices to carefully consider which options they can realistically comply with and minimize disruption to patient care.”

The final MACRA rule is expected to be released on or around November 1, 2016.

The AUA will continue to monitor MACRA implementation and will keep members posted as more information becomes available. Additionally, we are working on a compendium of tools to help members incorporate the new reporting requirements and payment models into practice. For more information, please contact R&