The Medicare Access and CHIP Reauthorization ACT (MACRA) of 2015 abolishes the Medicare Sustainable Growth Rate (SGR) payment formula. In this 45-minute webinar, practice management experts present the most critical aspects of this new payment paradigm, exploring how MACRA came to be and why it’s vital that you become familiar with its complexities.
In April 2014, Congress passed a 12-month patch to avert a 24.1 percent cut to Medicare physician payment per the Sustainable Growth Rate (SGR) formula. This patch legislation included a 0 percent update from Jan. 1, 2014 to April 1, 2014. The legislation also included other provisions that have typically been included with previous SGR patch legislation, such as an extension of the geographic practice cost index (GPCI) floor and a delay of the transition to ICD-10-CM/PCS until Oct. 1, 2015.
On March 26, 2015, the House of Representatives passed bipartisan legislation, HR 2, which repeals and replaces the flawed Medicare Sustainable Growth Rate (SGR) formula. Included in this legislation were provisions that physicians would receive a 0.5 percent update for the initial five years of the law while a new system, known as the Merit-Based Incentive Payment System or MIPS, is implemented. The MIPS program is effective in 2019. The legislation also provides for physician participation in Alternative Payments Models (APM). Read more about this legislation here. The Senate must pass this legislation by April 1 to avoid a 21 percent cut to Medicare payments.
ASA's Position on the Sustainable Growth Rate (SGR) formula:
ASA strongly supports Congress’ work to repeal, once and for all, the flawed Medicare Physician Fee Schedule Sustainable Growth Rate (SGR) formula. ASA looks forward to working with lawmakers and the Centers for Medicare and Medicaid Services (CMS) to play a meaningful role in helping to shape the implementation of new payment structures.
ASA opposes the across-the-board funding cuts known as sequestration.