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MACRA Implementation

The commenting period set by CMS on the MACRA implementation has ended now. Following that, the American Academy of Family Physicians (AAFP) asked the Centers for Medicare & Medicaid Services to reconsider and slow down with their Medicare Access and CHIP Reauthorization Act (MACRA) implementation.

Robert Wergin, chair of the AAFP Board of Directors said, “While our support for MACRA remains strong, we must state that we see a strong and definite need and opportunity for CMS to step back and reconsider the approach to this proposed rule which we view as overly complex and burdensome to our members and indeed for all physicians.”

He further added, “Given the significant complexity of the rule, we strongly encourage CMS to issue an interim final rule with comment period rather than to issue a final rule. The AAFP believes that our collaborative engagement with CMS has been productive and that providing a second comment period would allow us to further refine the policies to better capture those ideas and concepts that will lead to a successful program.”

Another complaint raised was regarding the initial performance start date for MACRA. Since the final rule will be issued around November 2016 and the start date is fixed as January 2017, most physicians will not have enough time to prepare. So the agency also suggested to extend the starting date to July 1, 2017.

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“The AAFP has been engaged in aggressive member education and practice transformation programs since the passage of MACRA in 2015. Despite these efforts, we remain concerned that a January 1 start date does not provide adequate time for education and practice adjustments that will be required to ensure the successful implementation of the quality payment programs in a majority of family physician practices,” Wergin said.

He further noted, “While we prefer that the performance period start in 2018, we recognize that this time frame creates program administration challenges that may be insurmountable for CMS. However, based on information provided by CMS, we believe that the establishment of the payment period on July 1 allows time for the AAFP to engage in member education and allows CMS to meet its program administration requirements and the requirements of the law.”

CMS’s plan to delay virtual groups until 2018 will have a negative effect on some family physicians. Small group and solo physicians who have been looking out for the virtual group for assistance will not have that chance. With many suggestions and complaints reported, CMS may need to reconsider their MACRA implementation.

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