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ACA may change, but MACRA is not going away

The ACA and MACRA are two separate laws, a policy expert reminds physicians. MACRA isn’t going away—so physicians must get ready.


Washington lawmakers are currently considering changes, including a possible replacement, to the Affordable Care Act. Many physicians are wondering if this means that physician payment changes brought on by the Medicare Access and CHIP Reauthorization Act (MACRA) will be delayed or cancelled, says Laura Wooster, AOA senior vice president of public policy.

“This is a good question, and the answer is that the ACA and MACRA are two separate laws, and MACRA is not going away,” Wooster says. “Physicians need to participate in MACRA in 2017 to avoid payment penalties.”

With MACRA, also known as the Quality Payment Program, solidly in place, DOs can comply with the law by choosing one of four participation options for 2017, according to the Centers for Medicare and Medicaid Services:

Merit-Based Incentive Payment System (MIPS) Test Submission: Submit a minimum amount of 2017 data to Medicare.

MIPS Partial Submission: Submit 90 days of 2017 data to Medicare.

MIPS Full Submission: Submit a full year of 2017 data.

Advanced Alternative Payment Model (APM) Participation: Applies to physicians who receive 25% of their Medicare payments or see 20% of their Medicare patients through an Advanced APM in 2017.

Note: Some physicians will be exempt from MACRA. You may be exempt if this is your first year billing Medicare, if you have less than $30,000 in Medicare Part B revenues, or have less than 100 Medicare Part B patients.

For more information on MACRA participation, view the AOA’s MACRA resources.

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