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Possible Delay in MACRA

Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt on July 13 told lawmakers that “CMS is considering delaying the start date for Medicare payment reform, which is set to go into effect January 1, 2017.”

Under the proposed Medicare payment reform, physicians will receive a composite performance score of 0-100 based on their performance in each of four categories used in the Medicare Incentive Payment System (MIPS) – quality, cost, clinical practice improvement and advancing care information. The score will determine which physicians are rewarded or penalized in their Medicare reimbursements beginning Jan. 1, 2017.

A delay is good news for physicians, since many are not prepared for the biggest payment shift in Medicare history. Almost four in 10 physicians in solo and small group practices predict an exodus from Medicare within their ranks because of the program’s new payment plan and its punishing penalties, a Medscape Medical News survey reveals. CMS estimates that 54 percent of all physicians in MIPS will receive a bonus, most of them in practices with more than 24 members, and 46 percent would be penalized.

In an interview with Medical Economics, U.S. Rep. Phil Roe said, “We’re going to be pushing for at least a six-month delay in the start date – while large health care systems likely will be able to meet the January 1 deadline. Small independent practices will not.”

AMA also lobbied for a delay in Medicare payment reform. AMA President Andrew W. Gurman, MD, praised Slavitt, Health and Human Services Secretary Sylvia Burwell and the Obama administration for giving physicians “a fair shot at success under MACRA.”

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