CMS locks in January 1, 2017 start date in final rule on new Medicare payment tracks under MACRA

The Centers for Medicare and Medicaid Services (CMS), on Friday, October 14, 2016, issued the heavily anticipated final rule on the Merit-based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Together, CMS is referring to the new payment tracks through MIPS and Advanced APMs as the Quality Payment Program (QPP).

MACRA repealed the sustainable growth rate (SGR) formula for updates to the Medicare Physician Fee Schedule and sets payment updates for all years in the future. Through the QPP, the law is intended to link Medicare payment updates to quality and performance and drive the health care payment system across all payers away from fee-for-service reimbursement models.

The first performance period under MACRA will begin on January 1, 2017, and the first payment adjustments under the law will take effect for 2019.

Continue reading “CMS locks in January 1, 2017 start date in final rule on new Medicare payment tracks under MACRA”

Major health care regulatory activity still to come under the Obama Administration

As many in the US prepare to shift their attention to the upcoming presidential debates and the final weeks of the campaign, the Obama Administration is poised to release some far-reaching regulations, which will have a significant effect on the health care marketplace, including a final rule on the new Medicare payment law and some changes intended to help shore up the health insurance Exchanges established under President Obama’s signature health care law.

Highlights of some of the most significant regulatory actions still to come in the final months of the Obama Administration are provided below.

Continue reading “Major health care regulatory activity still to come under the Obama Administration”

CMS provides clinicians flexibility under MACRA but retains 2017 start date for first performance period

Posted by Anne Phelps, Principal, US Health Care Regulatory Leader, Deloitte & Touche LLP and Daniel Esquibel, Deloitte Advisory Senior Manager, Deloitte & Touche LLP on September 9, 2016

In a blog post late Thursday, September 8, 2016, Centers for Medicare & Medicaid Services (CMS) Administrator Andy Slavitt announced two new options for participation in the Merit-based Incentive Payment System (MIPS) that are intended to give clinicians more flexibility to participate in the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Notably, the blog post states that the first performance period will still begin on January 1, 2017.

Continue reading “CMS provides clinicians flexibility under MACRA but retains 2017 start date for first performance period”

CMS releases comprehensive MACRA rules: New law poised to shape payment and delivery reform in the future

US Supreme Court building

Posted by Anne Phelps, Principal, US Health Care Regulatory Leader, Deloitte & Touche LLP, and Daniel Esquibel, Senior Manager, Deloitte & Touche LLP on April 28, 2016.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) fundamentally changes how physicians and other clinicians are reimbursed under the Medicare Physician Fee Schedule (PFS) and establishes new incentives that will drive payment and delivery reform efforts across the health care payor mix. The law will allow clinicians to develop new care models and encourages new collaborations between plans and hospitals to enter into new payment and delivery models. Importantly, the law was passed with overwhelming bipartisan support and continues to enjoy strong support from Republicans and Democrats in Congress, all but ensuring its continued implementation regardless of the outcome of the November elections.

The Administration this week issued its first major regulation under MACRA: late in the afternoon of April 27, 2016, the Centers for Medicare and Medicaid Services (CMS) released the long-awaited proposed rule1 on the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the law. Taken together, CMS is now referring to the two payment tracks as the Quality Payment Program (QPP).

Continue reading “CMS releases comprehensive MACRA rules: New law poised to shape payment and delivery reform in the future”