Early this morning, Congress reached a two-year budget deal that will increase federal funding for defense and non-defense discretionary programs. This deal will allow lawmakers to complete work on fiscal year (FY) 2018 spending measures, including appropriations for the Department of Health and Human Services.
To avoid another federal government shutdown while lawmakers finalize FY 2018 spending bills, Congress today passed another continuing resolution that includes numerous Medicare and other health care-related provisions.
The American Society for Gastrointestinal Endoscopy (ASGE) is pleased to share that the stop-gap spending measure amends the Medicare Access and CHIP Reauthorization Act to provide the Centers for Medicare and Medicaid Services (CMS) continued flexibility when it comes to how it implements the Merit-Based Incentive Payment System (MIPS). Specifically, the legislation makes several changes called for by ASGE, including:
- Allowing CMS to weight the cost performance category to not less than 10 percent for the second, third, fourth and fifth years of MIPS. Without a change in law, CMS would have been required to weight the cost category at 30 percent beginning with the 2021 payment year.
- Excluding Medicare Part B drug costs from MIPS payment adjustments.
- Allowing CMS flexibility in setting the MIPS performance threshold for years two through five. Without a change in law, CMS would have been required to institute, beginning with the 2021 payment year, a performance threshold set at the mean or median of the composite performance scores for all MIPS eligible professionals.
- Eliminating improvement scoring for the cost performance category for the second, third, fourth and fifth years of MIPS. Without a change in law, cost measures would be measured for improvement effective for the 2020 payment year.
“Physicians must be given the opportunity to succeed within the MIPS and alternative payment model payment structures,” said ASGE President Karen L. Woods, MD, FASGE. “We thank lawmakers for recognizing that more time is needed for CMS, working alongside physicians, to develop meaningful cost measures and to perfect a performance and scoring system that is fair and actionable.”
The physician community fought back an attempt by lawmakers to extend the Medicare misvalued code target that has resulted in across-the-board physician fee schedule reductions and which has most severely penalized specialties like gastroenterology that have experienced steep payment reductions due to code revaluations in recent years. Read ASGE’s letter to Congress.
The legislation, however, does reduce the statutorily set Medicare physician fee schedule update from .5 to .25 percent for 2019. While ASGE is disappointed this reduction was taken, it is pleased Congress took the important step of repealing the Independent Payment Advisory Board (IPAB). Absent repeal, IPAB could have been triggered for the first time as early as 2021, setting up a process that could have resulted in steep Medicare cuts to providers.
“Today’s action by Congress underscores the importance of physician advocacy,” said Dr. Woods. “With the leadership of the ASGE Health and Public Policy Committee and support of all our physician members, we have been able to produce important policy changes that will have a noticeable effect on the practice of gastroenterology.”
To learn more about ASGE's advocacy efforts visit the ASGE Advocacy webpage.