Today, the ACR (American College of Rheumatology) welcomed components of a new proposed rule from the CMS (Centers for Medicare & Medicaid Services) regarding the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Quality Payment Program (QPP) as consisting of various positive developments for rheumatology providers. Particularly, support has been expressed by the rheumatologists for CMS's proposals to enhance the threshold for Merit-Based Incentive Payments System (MIPS) exemptions, to extend "Pick Your Pace" flexibility for another year and to delay electronic health records (EHRs) requirements. Furthermore, the ACR supports keeping the cost performance category weighted at zero for another year beyond the year of 2018.
Earlier review of the proposed rule recommends that CMS has been listening to several uncertainties of the rheumatology community. "The ACR has made it a priority to give CMS with constructive response on how to make MACRA victorious for rheumatology practices, so we’re glad and boosted to see CMS address these concerns by offering more flexibility," claimed Dr. Sharad Lakhanpal, MBBS, MD, a practicing rheumatologist and president of the ACR. "We consider a user-centered approach is crucial to ensure the continued provision of high-quality rheumatologic care, and look forward to continued engagement with CMS on this problem."
The number of physician practices will be expanded by the proposed rule who are exempt from the Merit-Based Incentive Payments System (MIPS) reporting requirements to involve practices with less than $90,000 in Medicare revenue or fewer than 200 unique Medicare patients each year. Additionally, the proposed rule provides bonus points that are added to the final scores of MIPS for eligible clinicians who’re in small practices as well as a hardship exemption from the advancing care information performance category.
These changes are being supported by the ACR as they will help alleviate administrative burdens placed on small practices who deliver important rheumatologic care to rural and underserved populations.
The continuation of the "Pick Your Pace" flexibility program is also being supported by the ACR into the 2018 performance period. With extension of that program, practices could ignore penalties in the year of 2020 if they submit some quality data to the program in the year of 2018. Extending this program into next year's performance period will ease the transition period for providers as they shift into full compliance with the QPP (Quality Payment Program).
Additional changes highlighted in the proposed rule, like continuing to permit providers to use 2014 Edition certified electronic health records (CEHRT), maintaining the cost performance category weighted at zero for an extra year and increasing the availability and adoption of Advanced Alternative Payment Models were also greeted by the rheumatology community.
Dr. Angus Worthing, MD, a practicing rheumatologist and chair of the ACR's Government Affairs Committee claimed, "The ACR acknowledges CMS listening to its concerns and making better the provider flexibility with regards to MACRA requirements. We’ll sustain to thoroughly review the proposed rule and submit official comments to CMS in the coming weeks." In the meantime, the ACR has established a number of resources to assist rheumatologists understand MACRA, and will sustain to update members as latest information becomes available.