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ASCRS, Alliance of Specialty Medicine, AMA, and the Medical Community Call on Congress to Extend the MIPS Transition Period and Cost Category Flexibility and Make Technical Corrections to MACRA

This week, ASCRS joined with the Alliance of Specialty Medicine, the AMA, and the medical community in two letters to Congress urging small changes to the MACRA statute that would extend CMS’ authority to provide transitional flexibility and make technical corrections, specifically to exclude Part B drugs from MIPS penalties or bonuses and fix the definition of a small practice to include only MIPS-eligible clinicians. ASCRS and our colleagues in the Alliance are meeting directly with the committees of jurisdiction in both the House and the Senate beginning this week to push for these changes.

The MACRA statute, passed in 2015, gave CMS the authority to provide transitional flexibility in the first two years of MIPS. Specifically, CMS is not required to set the first two years’ MIPS performance thresholds based on the previous year’s mean or median scores and can reduce the weight of the Cost category. For 2017, to impact 2019 payments, CMS finalized the “Pick Your Pace” option and set the MIPS performance threshold at 3 points, so that any physician submitting minimal data would not be penalized. In 2018, CMS proposes to increase the threshold slightly, but still allow physicians to avoid a penalty by reporting minimal data for performance Year 2018. CMS also reduced the weight of the Cost category to 0% in 2017 and proposes to again in 2018. ASCRS, the Alliance, and the medical community are asking Congress to extend that transitional authority for three additional years before CMS must set the MIPS performance threshold at the mean or median of the previous year’s score or increase the weight of the Cost category. This will allow physicians additional time to implement the program and for new cost measures with improved attribution and risk adjustment to be developed.

In addition, the letters urge technical fixes to the MACRA statute that would correct issues that have become apparent since the bill was enacted. We ask Congress to clarify that Medicare Part B drugs and other items and services outside the physician fee schedule are not included in the application of MIPS payment adjustments and determination of MIPS eligibility; clarify that a “small practice” size is determined based on the number of MIPS-eligible clinicians; and explicitly authorize the Physician-focused Payment Model Technical Advisory Committee (PTAC) to provide technical assistance to developers of Advanced Payment Models.

We will keep you updated.