MedPAC to Meet Next Week to Vote on Policy Replacing MIPS Aimed at Moving Physicians in to APMs or Virtual Groups Scored on Population Health Measures; Congress Unlikely to Act on MedPAC’s Recommendations

Next week, the Medicare Payment Advisory Commission (MedPAC) will meet and likely vote on a policy recommendation to replace MIPS, and seek to move physicians out of fee-for-service and into Advanced APMs or a Voluntary Value-Based Program (VVP), which would require physicians to identify other physicians to join with in large virtual groups to be measured with population-health claims-based measures. ASCRS has joined with the Alliance of Specialty Medicine to oppose this proposal as it was being developed, since there are no specialty-specific Advanced APMs, and the population-based measures MedPAC proposes to use are not relevant to specialists. While we remain concerned that MedPAC continues to advance this flawed proposal, it is important to recognize that MedPAC is an advisory body with no force of law. Implementing this proposal would require Congress to act and make major changes to the MACRA statute. Congress rarely follows MedPAC’s advice and is not likely to make changes to MACRA, which had broad bipartisan support when it was passed in 2015.

While ASCRS and the Alliance continue to think there must be a viable fee-for-service option in Medicare and MIPS should remain in place, we are still seeking limited legislative fixes to the MACRA statute to ensure physicians can be successful in the program. We are asking Congress to give CMS the authority to extend the MIPS transition period for three additional years before the performance threshold must be set at the mean or median, keep the Cost category weight at lower than the required 30% for three additional years, and to clarify that MIPS eligibility determinations and payment adjustments be limited to just physician professional services. We are working with the medical community to advocate that these changes to MACRA be included in any end of the year spending package or Medicare extenders bill.

We will continue to keep you updated.