Macra

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), P.L. 114-10, became law in the United states on April 16, 2015. This is also known as the "SGR repeal". This repealed the formula for the sustainable growth rate (SGR), which had required mandatory reductions in reimbursements by Medicare for services. Instead, MACRA provides for annual increase in payments of 0.5 percent, from July 1, 2015, through 2019.

MACRA removed the requirement that physicians who opt out of Medicare must renew their opt-out status every two years. Under MACRA, physicians who opt out on or after June 16, 2015, do not have to renew their opt-out status.

This bipartisan law also establishes a merit-based incentive payment system (“MIPS”), which becomes mandatory beginning in 2019,^[1] MIPS looks to four categories to determine a physician's score for reimbursement purposes:

(1) measures of quality

(2) metrics for efficiency, such as controlling the overall cost of the medical care;

(3) whether there is a meaningful use of EHR, or electronic health records; and

(4) whether there are activities undertaken to improve clinical practice.

MACRA includes protections against malpractice lasuits using the Medicare quality program standards. There will also be incentive payments to physicians who participate in payment models other than MIPS, and supposedly there will be technical support to help smaller practices who choose the alternative payment models or participate in a fee-for-service incentive program.

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