ASA Seeks Regulatory Relief for 2016 Payment Program Participation

The American Society of Anesthesiologists (ASA), along with more than 40 medical associations and groups, petitioned the Centers for Medicare & Medicaid Services (CMS) to use its authority to relax penalties on 2016 quality reporting requirements. The request, based upon the recently signed executive order on regulatory relief, addressed three major 2016 quality reporting programs:

1.            CMS should create a hardship exemption for physicians who attempted to report PQRS in 2016 but were unsuccessful due to the complexity of the reporting requirements and the significant number of measures that were required.

2.            CMS should hold harmless any physician who satisfactorily reported PQRS (or obtained an exemption described above) from any quality-tiering adjustments under the Value-Based Payment Modifier. Instead, physicians should be allowed to elect to the be scored under the quality-tiering matrix.

3.            CMS should extend the EHR Incentive Program hardship exemption beyond physician anesthesiologists to all physicians who encountered a significant level of administrative burden.

ASA advocated this position, in part, based also upon regulatory rules and regulations applicable to the 2017 implementation of the Medicare Access and CHIP Reauthorization Act (MACRA). Although MACRA sunset PQRS, VM and the EHR Incentive Program, MACRA authorized the continuation of several features of these programs (the Quality, Cost and Advancing Care Components of the Merit-based Incentive Payment System or MIPS). In 2017, individual physicians may need to only report one measure, one time to avoid any penalties under MACRA.

By lessening the penalties on physician anesthesiologists, CMS could better establish continuity among previous and current quality reporting programs. Although CMS has not made any changes to these 2016 programs yet, ASA expects that CMS would have to release additional guidance or proposed rules to address these requested changes.

Please visit the ASA Quality and Regulatory Affairs website for more information on quality reporting programs. For additional information, please contact the ASA Department of Quality and Regulatory Affairs (QRA) at (202) 289-2222 or via e-mail at [email protected].