By: Vasilios J. Kalogredis, Esquire

On October 14, 2016, CMS released its final rule for the Medicare Access and CHIP Reauthorization Act (“MACRA”).  Detailed information as to this massive (over 2,000 pages) document may be gleaned from the below links.

 

Set forth below are some key points for doctors to understand:

1. MACRA takes effect on January 1, 2017. However, there are relaxed thresholds to avoid negative Medicare payments.  Doctors may choose to start collecting performance data as late as October 2, 2017.

2. A doctor is affected by MACRA if he/she bills Medicare more than $30,000 annually or provides care for more than 100 Medicare patients in a year.

3. Ignoring MACRA could be costly. If no data is submitted, there will be a 4% negative payment adjustment in 2019.

4. Even though this is called a final rule, CMS has indicated that there will be changes in the future.

5. This new program’s purpose is to impact one’s Medicare reimbursement (up or down) based on how well one performs from a “quality” standpoint. That will be a massive change from the historical “fee-for-service” model.

Accompanying the announcement is a new Quality Payment Program website, which will explain the new program and help physicians easily identify the measures most meaningful to their practice or specialty.

For More Information:

• Final Rule and Executive Summary
• Press Release
• Fact Sheet
• Quality Payment Program website