CMS Solicits Advice on New Medicare Payment Rules

The Centers for Medicare &Medicaid Services (CMS), in its physician fee proposal for 2016, seeks public input on several provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This is the new law that replaces the sustainable growth rate formula for Medicare physician payments with a new hybrid compensation approach.

CMS is soliciting advice on how to write regulations for the new Merit-Based Incentive Payment System (MIPS), which, starting in 2019, will consolidate the government's electronic health records (EHR) incentive program, the Physician Quality Reporting System, and the value-based modifier program. MIPS will adjust physicians' payments up or down, depending on their performance on quality, resource use, meaningful use of EHRs, and clinical practice improvement.

CMS also seeks input on how to implement MACRA's alternative payment mechanisms (APMs), which cover patient-centered medical homes, accountable-care organizations, and payment bundling. Physicians who receive a certain percentage of their revenue through APMs will receive a 5% bonus each year from 2019 to 2024.

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