During Senate proceedings on July 13, CMS Acting Administrator Andy Slavitt and senators showed that they have heard and understand the AAFP's sharp call to slow down plans for implementing the Medicare Access and CHIP Reauthorization Act (MACRA).
Speaking before the Senate Finance Committee(www.finance.senate.gov), Slavitt said he knows small physician practices might not have enough time to prepare for the important changes in Medicare payment if they go into effect on Jan. 1 as planned.
A final rule on new payment models under MACRA is expected to be announced in November. Sen. Orrin Hatch, R-Utah, chairman of the committee, noted the short period between then and the planned implementation date.
"Physicians will only have about two months before the program goes live," Hatch said. "This seems to be a legitimate concern. What options is CMS considering to make sure this program gets started on the right foot?"
Slavitt responded that CMS is open to alternatives that include postponing implementation and establishing shorter reporting periods. He acknowledged several times during the hearing that the more time physicians have to spend reporting data, the less time they can devote to patient care.
"We're putting in an awful lot of change," Slavitt told the committee. "Too much change on top of an already burdened physician practice is not where we should be going."
Slavitt's stance is a good start for family physicians. The AAFP sent CMS a detailed letter on June 24 that called on the agency to, among other changes, delay implementation of MACRA until 2018 and set aside 2017 as a preparation year. The AAFP was also critical of the agency's decision to delay formation of virtual groups until 2018; the groups would be a crucial support tool for smaller physician practices.
Slavitt also suggested that reporting requirements could be adjusted to ease the burden on physicians. For instance, CMS could obtain data through an automated database such as a registry. He also said practices that demonstrate strength in a particular area of care might not have to report those data and that physicians who do not see a high volume of Medicare patients might not be required to report data.
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