This Week – March 25, 2017

This Week in Washington, D.C.

  • ACA Repeal Watch: House Cancels AHCA Vote at the Last Minute
  • MACRA Tidbit for the Week: ACG Working to Reduce Burdens Heading into MACRA’s Full Impact

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

ACA Repeal Watch: House Cancels AHCA Vote at the Last Minute

House Republicans and President Trump were forced to cancel a House vote on the American Health Care Act (AHCA) on Friday afternoon, after it became clear that there were not enough votes to pass the bill. The vote was originally scheduled for Thursday, 7 years to the day that the Patient Protection and Affordable Care Act (ACA) was signed into law.  On Thursday evening, President Trump urged the House to hold the vote on Friday, even without a clear picture of whether or not it would pass.  According to some insiders, the House Republicans were just 8 votes shy of passing the bill on Thursday evening.  By Friday afternoon, however, the vote count for those supporting started to get worse as both conservative and moderate Republicans began jumping ship for various reasons.

The week began with House Republican Leadership unveiling an amended version of the bill, “AHCA 2.0,” to both woo conservative Republican House members into supporting the bill, and to keep moderate Republicans from opposing.  As discussed over these past few weeks, ACG had been closely monitoring this political balancing act led by Speaker Paul Ryan (R-WI) and was preparing for this outcome.  As the week progressed, President Trump and Speaker Ryan were brokering deals with House Republicans on this amended version of the AHCA, thus finalizing an “AHCA 3.0” by the week’s end.

ACG’s Take: Opposition to Changes in Essential Health Benefits:

Read the full post here.

ACG Working to Reduce Burdens Heading into
MACRA’s Full Impact

ACG and 86 state and specialty medical societies recently submitted a letter requesting the Centers for Medicare and Medicaid Services (CMS) reduce the administrative burden and provide for hardship exemptions for the 3 Medicare programs that will sunset by the end of 2018 (by name at least) and before MACRA adjusts your reimbursement in 2019.

Remember: there is a two-year lag in the “reporting year” versus the “reimbursement year.” Thus, CY 2017 is the first reporting year under MACRA, but will impact CY 2019 Medicare fee-for-service reimbursement.

The letter requests CMS to establish a hardship exemption due to regulatory burdens of these programs: Meaningful Use, the Physician Quality Reporting System (PQRS), and the Value-based Payment Modifier for 2018— the final year in which these programs will impact your reimbursement.  Thus, there should be no penalty in 2018 as GI practices deal with the full reporting requirements under MACRA (impacting your 2020 reimbursement).

CY 2017 is the MACRA “Transition Year”: Here is what you need to know

CMS views CY 2017 as a transition year to ease Medicare providers into MIPS.  What does this mean?  ACG members who submit 90 consecutive days of 2017 data will avoid a payment cut, and may earn a bonus in 2019.  You will not get extra points, or larger bonuses, for submitting 90 days vs. a full calendar year.  It is simply a choice.  If you don’t send in any 2017 data, then you will receive a 4% payment cut in 2019.  If you submit a minimum amount of 2017 data to Medicare, you can avoid a payment cut.  For example, submitting one quality measure for one patient, or attesting to one improvement activity will suffice.