MACRA Discussed on Capitol Hill
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Ways and Means Hearing on MACRA

Earlier this month, the House Ways and Means Health Subcommittee members hosted Centers for Medicare and Medicaid Services (CMS) Acting Administrator Andy Slavitt to discuss the Administration’s plan for implementing the bipartisan Medicare Access & CHIP Reauthorization Act of 2015 (MACRA). Signed into law last year, MACRA reformed how doctors are reimbursed for treating Medicare patients and creates new two tracks for payment. First, it replaces the existing Physician Quality Reporting System (PQRS), Value-Based Modifier, and “Meaningful Use” of Electronic Health Records (EHR) programs with a new, single Merit-Based Incentive Payment System (MIPS) program that expands the pay-for-performance incentives in the fee-for-service system. The second track, Alternative Payment Models (APMs), provides bonus payments for physicians who participate in Advanced APMs that hold providers financially accountable for health care costs.

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Orthopaedic Surgeons Meet with Congress for NOLC

On Thursday, May 5, 2016, more than 300 orthopaedic surgeons from around the country converged on Capitol Hill to meet with congressional offices as part of the 2016 American Association of Orthopaedic Surgeons (AAOS) National Orthopaedic Leadership Conference (NOLC).

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Legislators Introduce Legislation on Hospital Reform

House Ways and Means Health Subcommittee Chairman Pat Tiberi (R-OH) and Ranking Member Jim McDermott (D-WA) recently introduced the Helping Hospitals Improve Patient Care Act (HIP-C), a bipartisan bill that is a part of the committee’s ongoing effort to promote greater access, increase choices, and improve the quality of health care. According to the policymakers, this legislation “will support current efforts to develop outpatient facilities and allow hospitals to treat more low-income and cancer patients.”

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Legislators Suggest Tax Reform to Improve Health Care

The House Ways and Means Health Subcommittee, chaired by Rep. Pat Tiberi (R-OH), held a hearing where a group of bipartisan members of Congress discussed their ideas for modernizing the tax code to improve our health care system and deliver high-quality, affordable, consumer–driven options to all Americans.

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What We’re Reading

Bill Targets Socioeconomic Factors in Hospital Readmissions, Modern Healthcare, 5/19/16

GOP Lawmakers Unveil Obamacare Replacement Bill, The Hill, 5/19/16

Specialty Drug Spending Increased 26 Percent, Morning Consult, 5/19/16

Providers, Pharma Call on Lawmakers to Properly Fund Opioid Bills, Modern Healthcare, 5/19/16

Nonprofit Hospitals Adjust to Attract Investors, The Wall Street Journal, 5/18/16

Senate Votes to Advance Emergency Funding to Fight Zika Virus, The New York Times, 5/17/16

Republicans Say Medicare Drug Proposal Needs Safeguards, Morning Consult, 5/17/16

ER Docs Sue HHS Over Out-Of-Network Payments, Modern Healthcare, 5/17/16

Price Spikes for Life-Saving Drug, Politico, 5/16/16

Wal-Mart Pairs With McKesson to Buy Generic Drugs More Cheaply, Bloomberg, 5/16/16

House Challenge to Health Law Could Raise Premiums, Administration Says, The New York Times, 5/16/16

Insurance Options Dwindle in Some Rural Regions, The Wall Street Journal, 5/15/16

This Health-Care Trend Could Make Your Hospital Stay More Expensive, The Washington Post, 5/13/16

Hillary Clinton Takes a Step to the Left on Health Care, The New York Times, 5/10/1


Capitol Club Members Attend DC Reception

For the second year in a row, the Orthopaedic Political Action Committee (PAC) congressional reception kicked off the American Association of Orthopaedic Surgeons (AAOS) National Orthopaedic Leadership Conference (NOLC). Members of the Orthopaedic PAC’s top donor level, the Capitol Club, joined members of Congress and congressional staff on the roof of the W Hotel in Washington, DC for a reception to thank them for their generous support of the PAC. Members of Congress who attended included Reps. Ami Bera (D-CA), Don Beyer (D-VA), and Barbara Comstock (R-VA).

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Election 2016 Graphic of the Week

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CMS Finalizes Quality Measure Development Plan

On May 2, 2016, the Centers for Medicare and Medicaid Services (CMS) posted their final Quality Measure Development Plan on the CMS website ( The Quality Measure Development Plan is a strategic framework for clinician quality measurement development to support the new Merit-based Incentive Payment System (MIPS) and advanced alternative payment models (APMs). CMS posted their draft plan in December, 2015 and asked for stakeholder feedback (read the AAOS feedback letter online here).

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BPCI Models 2-4 Extended

On April 18, 2016, the Centers for Medicare and Medicaid Services (CMS) announced that participants in the Bundled Payments for Care Improvement (BPCI) initiative will have the opportunity to extend their participation in Models 2, 3 and 4 through September 30, 2018. This extension applies to the first batch of awardees in Models 2, 3, and 4 that began in October 2013 (who were scheduled to end their participation on September 30, 2016) along with those that joined later in 2014.

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2015 EHR “Meaningful Use” Hardship Exemption Information

Note: visit for all the latest updates on health information technology and meaningful use, including information on applying for a 2015 exemption.

In an effort to allow physicians to avoid a potential 3 percent meaningful use penalty in 2017, a law was passed by Congress that allows the Centers for Medicare & Medicaid Services (CMS) to consider hardship exceptions for categories of eligible professionals (EPs) and hospitals in a new, more streamlined process. Physician groups, including the American Association of Orthopaedic Surgeons (AAOS), lobbied for the legislation because the delayed release of modifications to the Stage 2 of the program left physicians with insufficient time to report under the modified requirements (read about the changes in an earlier Advocacy Now article here).

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