Medicare reimbursement undergoing big changes

On April 27, 2016, CMS issued a Notice of Proposed Rulemaking (NPRM) to put in place key parts of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This bipartisan legislation replaces the flawed Sustainable Growth Rage formula by paying clinicians for the value and quality of care they provide. This proposed rule will make changes through a single framework called the “Quality Payment Program”. In the final rule CMS has indicated a 2-year look back period, which means your performance in 2017 will determine your reimbursement in 2019 when the program is set to begin. To ensure our members have the information and resources to make this transition we have provided information below.

CMS Quality Payment Program

• https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html

CMS Final Rule

• https://www.gpo.gov/fdsys/pkg/FR-2016-11-04/pdf/2016-25240.pdf

AMA Medicare Payment Reform website

• http://www.ama-assn.org/ama/pub/advocacy/topics/medicare-physician-payment-reform.page

Here you’ll find information about the MACRA law, a checklist to prepare, and information to help you understand MIPS and APMS.

Practice Transformation Network

• http://www.khconline.org/kansas-ptn-overview

The PTN offers free resources to Kansas clinicians through the Compass Practice Transformation Network, led by the Kansas Healthcare Collaborative.

Postition paper from Texas Medical Association

• Our friends at the Texas Medical Association created this helpful position paper which provides a summary of the upcoming changes and how it may affect physicians.

Contact This email address is being protected from spambots. You need JavaScript enabled to view it., KMS Director of Health Care Finance with any questions or concerns.