Dear Secretary Burwell:
In April 2015, Congress passed, and the president signed into law, the Medicare Access
and CHIP Reauthorization Act (P.L. 114-10). MACRA replaced the flawed sustainable
growth rate (SGR) formula with the Quality Payment Program (QPP), which represents a
new approach to paying providers based on the value and quality of their care through the
Merit-based Incentive Payment System (MIPS) and other alternative payment models
(APMs). On April 27, 2016, the Centers for Medicare & Medicaid Services (CMS) issued
a proposed rule implementing the QPP. The final rule is expected to be published by
November 1, 2016 for implementation on January 1, 2017.
I have heard from numerous constituents regarding concerns with the implementation of
MACRA. Given those concerns, I am writing to request that CMS: (1) modify the initial
start date of MIPS so physicians and practices have adequate time to prepare for the new
program; (2) minimize the reporting burden, particularly during the initial transition
period; (3) provide more flexibility for small and solo practices; and (4) encourage parity
in the Physician-Focused Payment Model Technical Advisory Committee (PTAC) review
process to promote specialty-focused models. For each of these key requests, additional
information is provided below.
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