This Week – February 4, 2017

This Week in Washington, D.C.

  • ACA Repeal Watch: Week of Congressional Hearings
  • Important Dates for ACG Members: Don’t Forgot CY 2016 Quality Reporting Deadlines
  • MACRA Tidbit for the Week: How will repealing the ACA impact MACRA?

From ACG National Affairs Committee Chair, Whitfield L. Knapple, MD, FACG

ACA Repeal Watch: Week of Congressional Hearings

On Wednesday, February 1st, the U.S. Senate Health, Education, Labor, and Pensions (HELP) Committee held a hearing on the impending fate of the Patient Protection and Affordable Care Act (known as the “ACA”), titled “Obamacare Emergency: Stabilizing the Individual Health Insurance Market.” Overlapping themes included: the need for a clear layout of plans provided to the insurance markets to ensure transparency and stability, and empowering the states to tailor to their own unique markets.  The current shortcomings and areas of improvement of the ACA were discussed, including the need for more effective risk pooling mechanisms, shortening the 90-day grace periods, tightening special enrollment opportunities, and easing reporting burdens for employers.  Panelists emphasized that action is needed by the end of March 2017 in order for the market to adequately plan for 2018, and to avoid the risk of losing insurers. The Committee Chair, Senator Lamar Alexander (R-TN) also suggested leaving “a separate discussion” for reforming Medicare and Medicaid.

On Thursday, February 2nd, Rep. Greg Walden (R-OR), Chairman of the U.S. House of Representatives Committee on Energy and Commerce, held a hearing titled “Patient Relief from Collapsing Health Markets,” which focused on several pieces of legislation introduced by Republicans intended to aid with the improvement of the existing insurance markets.  These bills include: the Plan Verification and Fairness Act of 2017 (HR 706), which requires patients utilizing special enrollment periods to provide additional pre-enrollment verification; the Health Coverage State Flexibility Act of 2017 (HR 710), which updates the length of the allowed grace period to encourage increased, active coverage; the State Age Rating Flexibility Act of 2017 (HR 708), which updates the current age rating ratio from 3-1 to 5-1; and the Preexisting Condition Protection and Continuous Coverage Incentive Act of 2017, a draft bill designed to protect those with pre-existing conditions  In his opening statement, Rep. Walden stressed his current concerns with the ACA and the need for immediate action, that “…it’s time to end the partisan rhetoric and actually come to the table and solve these problems.”

HHS Nomination Update & more: read the full blog here.


Important Dates for ACG Members: Don’t Forgot CY 2016 Quality Reporting Deadlines 

2016 Meaningful Use Attestation Period (Jan 3 – Feb 28)

CMS announced that the attestation period for the 2016 reporting year is now open for those ACG members who have participated in the 2016 Medicare Meaningful Use Program.  The attestation period will end on Feb. 28.  Providers must attest by the deadline to avoid a 2018 payment adjustment.

CMS has released attestation worksheets as a guide to prepare for reporting for 2016 Meaningful Use attestation.  Providers can log their Meaningful Use measures for each objective in the worksheet and use it as a reference when attesting for the Medicare 2016 Meaningful Use Program in CMS’ Registration and Attestation System.

2016 PQRS Group Practices Reporting Option (GPRO) (January 17 – March 17)

If you and your practice are reporting CY 2016 PQRS data using the Group Practice Reporting Option (GPRO) CMS web interface, your practice’s data must be submitted between January 17 and March 17, 2017.

How will repealing the ACA impact MACRA?

MACRA will stay put.  Why?

MACRA has significant bipartisan popularity on both sides of the aisle in the U.S. House of Representatives and U.S. Senate.  The U.S. Senate passed MACRA in April 2015 by a 92 to 8 margin. The U.S. House passed MACRA in March 2015 by a 392 to 37 margin.  Both Democrats and Republicans have stated that their hope is to transition into a more “value-based care,” and see MACRA as the “vehicle” to do this.  So there appears to be little incentive for President Trump or the Republican-controlled Congress to repeal this law.

Repealing the ACA could very well impact MACRA.  How?

Remember: MACRA does not create new alternative payment models; it provides greater incentives to join one.  While the 2017 health care issues focus on the ACA and access to health care via greater access to health insurance– not necessarily how Medicare pays providers.  President Obama’s 2010 health care law authorizes the Medicare ACOs (“shared savings program”) as well as the Center for Medicare and Medicaid Innovation (CMMI).  Republican leaders in Congress have already started putting the wheels in motion to repeal parts of the ACA, and throughout 2016, Republicans criticized the CMMI for having too much authority.  So repealing the ACA could also repeal CMS’ authority to implement ACOs and other APMs under MACRA.  However, please note that Republicans have started speaking with a softer tone regarding CMMI, now that they control both Congress and the Oval Office.  CMMI may likely still exist, but with some “guardrails,” according to many Republican health policy staffers on Capitol Hill.

Also: there may be an opportunity to reduce MACRA reporting requirements and administrative burdens.  The Trump Administration has already stated its intention to lower regulatory burdens for health care providers.  This may be good news for ACG members and GI practices.  Stay tuned.

More on MACRA: It may be easy to at least avoid a payment cut in 2017.

ACG Hopes to Keep This Simple: We compiled a detailed overview for you, hopefully in a simplified fashion and in plain English.  Making $ense of MACRA.