TMA: Federal Legislation Needed to Continue Successful MIPS Rollout

Two provisions of the Medicare Access and CHIP Reauthorization Act (MACRA) that will expire in the spring should be extended for another three years to ensure a smoother rollout of the Merit-Based Incentive Payment Program (MIPS) under the new Quality Payment Program, TMA and other medical societies have told federal lawmakers.

Specifically, the societies are asking that the cost category under MIPS continue to be weighted at zero percent, as was done in 2017 and has been proposed for 2018, instead of the full 30 percent that would be required in 2019 when the provision expires next year. 

Because the program is still under development, the zero weight accurately reflects the complexities of cost measurement and does not discourage clinicians from caring for high-risk and medically complex patients, as was the case under the value-based modifier that MIPS replaced, the associations said.

The associations also are requesting that the Centers for Medicare & Medicaid Services continue to be flexible in selecting a target performance threshold. 

Gradually increasing the performance threshold gives physicians a chance to implement practice changes as they gain experience, the associations said. It also ensures that the performance threshold is not set too high, which could discourage participation or negatively impact practices with fewer resources.

In addition, the societies asked that changes be made to other MACRA provisions, including: 

  • Clarifying 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 MIPS eligibility;
  • Rationalizing what is considered a "small practice"; and
  • Explicitly authorizing the Physician-Focused Payment Model Technical Advisory Committee to provide technical assistance to developers of advanced payment models.

Action, Oct. 17, 2017

Last Updated On

January 12, 2018

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