Your Medicare reimbursement will be cut unless Congress acts to make critical improvements to MACRA.
After many years of strong advocacy by ACEP, the AMA and other physician organizations, the flawed Sustainable Growth Rate (SGR) update system used to calculate Medicare reimbursement rates was replaced by Congress in 2015 with the “Medicare Access and CHIP Reauthorization Act” (MACRA), which got rid of the SGR and took steps to shore up physicians’ ability to care for Medicare patients.
Since that time, ACEP has worked closely with federal lawmakers and the Centers for Medicare & Medicaid Services (CMS) to implement key provisions of this law and address areas that need improvement. As you may know, MACRA provided for modest annual reimbursement increases of 0.5 percent for the first five years to give medical societies time to establish viable Advanced Alternative Payment Models (AAPMs), and physicians an opportunity to transition away from fee-for-service and into such value-based care. However, CMS hasn’t approved nearly enough APMs during that time.
While those half percent increases weren’t even enough to keep up with inflation, under MACRA law they go away entirely at the end of this year, leaving physicians with NO payment increases at all in Medicare under MACRA for the upcoming years 2020-2025. Unfortunately, Congress failed to extend the MACRA update for 2020, meaning that physicians reimbursements will remain the same as they were in 2019.
Congress is extending several health programs through May 22, 2020, which may provide an opportunity for them to ensure this critical stability for physicians who treat Medicare beneficiaries. It’s crucial they hear from ACEP members when they return from recess in January.