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Senate Finance Hearing Examines MACRA Implementation and Progress; Witnesses Call for Extended Positive Payment Updates and Advanced APM Bonuses

On Wednesday, the Senate Finance Committee held a hearing on physician payment reform under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and how it could be further improved.

In the hearing, Medicare Physician Payment Reform After Two Years: Examining MACRA Implementation and the Road Ahead, the committee discussed how well MACRA is meeting its goals and, with the help of witness testimony, discussed ways to improve implementation of the law. Witnesses at the hearing represented a number of physician organizations and included Barbara L. McAneny, MD, president of the American Medical Association (AMA); John Cullen, MD, FAAFP, president of the American Academy of Family Physicians (AAFP); Frank Opelka, MD, FACS, medical director for quality and health policy at the American College of Surgeons (ACS); Scott Hines, MD, director of the American Medical Group Association (AMGA); and Matthew Fiedler, PhD, USC-Brookings Schaeffer Initiative for Health Policy fellow at the Brookings Institution.

During the hearing, all the witnesses recommended Congress take action to extend for additional years, or permanently, the 5% bonus payment for physicians participating in Advanced APMs because of the relative lack of APMs currently and the time it takes for physicians to develop and implement them. In addition, Drs. McAneny, Opelka, and Cullen all called for extending the positive payment updates for all physicians before they expire at the end of 2019. In his testimony, Dr. Opelka complained that MIPS is not well suited to surgeons but noted that specialties with single-source clinical data registries, such as ophthalmology and the IRIS Registry, are successfully participating in the program. In written testimony submitted prior to, but not discussed during the hearing, Dr. Cullen of the family physicians expressed support for proposals put forward in the President’s 2020 budget and by the Medicare Payment Advisory Commission to reduce payments for surgical procedures to increase payment for primary care physicians.

As you know, ASCRS continues to advocate for the retention of MIPS and a fee-for-service option in Medicare Part B. We support the extension of positive payment updates and the 5% bonus for participation in Advanced APMs. We will keep you updated.

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