Passage of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA): The “Doc Fix”

The President has signed into law bipartisan bill H.R. 2, the “Medicare Access and CHIP Reauthorization Act of 2015,” which permanently repeals the flawed Sustained Growth Rate (SGR) formula and replaces it with a stable Medicare payment system that rewards physicians for providing high-quality, high-value healthcare. Without this new law, physicians would have faced a 21.2 percent decrease in Medicare payment rates scheduled to take effect on April 1, 2015.

The new law replaces the SGR formula with positive rate increases for 4.5 years and implements a long-term Medicare value-based payment approach that harmonizes the features of the Physician Quality Reporting System (PQRS), Meaningful Use (MU), and the Value-Based Payment Modifier (VBM). It also incentivizes physicians to participate in Alternative Payment Models (APMs). Additionally, the law includes provisions to continue several other policies that, unless extended, would expire soon (often referred to as extenders).

The new law goes into effect immediately to address Medicare payment rates to physicians for services rendered April 1, 2015.

In a new paper, Manatt Health examines the key provisions of the “doc fix,” reviews highlights of Medicare and other extenders, discusses the extension of CHIP and explores key provisions of offsets.

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