On April 16, 2015, President Barack Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The bill permanently transforms the structure of Medicare physician reimbursement and enacts several changes to Medicare payment, program integrity and policy provisions that will affect both health care providers and pharmaceutical/medical device manufacturers. The most notable change, according to a Reed Smith client alert written by Deb McCurdy, Elizabeth Carder-Thompson, Dan Cody, Gail Daubert, Tom Greeson, Paul Pitts, Trey Andrews, Katie Hurley and Rahul Narula, is the repeal of the Sustainable Growth Rate formula, ending an era in which Medicare physician fee schedule rates were subject to regular cuts and temporary adjustments by Congress. Under MACRA, physician payment updates will now pertain to quality, value and participation in alternative payment models.
Other changes under MACRA include a two-year extension of the Children’s Health Insurance Program (CHIP), a reduction of market basket updates for post-acute care providers, a revision of inpatient hospital payment rate updates, a restructuring of reductions under the Medicaid disproportionate share hospital program, an implementation of additional income-related adjustments for Medicare Part B and Part D premiums, and a ban on first-dollar Medigap coverage policies.
To read the full alert, click here.