Medicare Access and CHIP Reauthorization Act of 2015
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| Long title | An Act to amend Title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and strengthen Medicare access by improving physician payments and making other improvements, to reauthorize the Children's Health Insurance Program, and for other purposes |
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| Nicknames | Permanent Doc Fix |
| Enacted by | the 114th United States Congress |
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| Public law | Pub.L. 114–10 |
| Codification | |
| Acts amended | Social Security Act Balanced Budget Act of 1997 |
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Lua error in package.lua at line 80: module 'strict' not found. Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), (H.R. 2, Pub.L. 114–10) commonly called the Permanent Doc Fix, is a United States statute. It changes the payment system for doctors who treat Medicare patients. It revises the Balanced Budget Act of 1997. It was the largest scale change to the American health care system following the Affordable Care Act ("ObamaCare") in 2010.
Provisions
MACRA's primary provisions are:[1]
- changes to the way Medicare doctors are reimbursed
- increased funding
- extension to the Children's Health Insurance Program (CHIP).
MACRA related regulations also address incentives for use of health information technology by physicians and other providers.
Under MACRA, the Secretary of the Department of Health and Human Services (DHHS) is tasked with implementation of a Merit Based Incentive[2] (MIP), an incentive program that consolidates three incentive programs into one, for eligible physicians. The legislation allows for Advanced Alternative Payment Models[3] (APM). In 2026, the conversion factor for both programs will be set at 0.75%.
The Government Accountability Office in partnership with DHHS is set to assist in the implementation of nationwide electronic health records[2] (EHR), while simultaneously comparing and recommending such programs for providers; the EHR goal is set for December 31, 2018 under MACRA.[1]
The US is set to transition from a fee for service system, which allowed physicians and providers to bill Medicare and Medicaid for services they provided to their patients, to a pay for performance based system using MIP, APM, and Accountable Care Organizations (ACO). The new model will now require the provider to provide information on the quality of service being given, how valuable it is to the patient, and accountability that provider has to the treatment being performed.[4]
Related
References
External links
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