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Medical societies call on Congress to provide MACRA flexibility — 4 insights

The American Gastroenterological Association and Alliance of Specialty Medicine urged legislators to increase flexibility around the Merit-based Incentive Payment System.

The AGA took issue with four particular aspects of MIPS. Here's what you should know:

1. Cost category weight — AGA wants Congress to allow HHS to set the cost category of MIPS at a rate lower than the 30 percent required by law in 2019.

CMS set the rate at 0 percent in 2017 and has proposed to keep the rate at 0 percent in 2018. The AGA is worried CMS will not have the proper amount of time to calculate cost measures before the steep increase in 2019.

2. Performance threshold — Similar to the aforementioned cost category weight argument, AGA wants Congress to allow HHS to set the MIPS performance threshold at a level that'll reflect physician readiness instead of what is required under law.

3. Application of MIPS to Part B drugs — The AGA wants MIPS payment adjustments to only apply to physician services and not physician-administered drugs.

4. Definition of a small practice — The AGA is seeking clarity over the definition of a small practice. They would like Congress to define a small practice as one that includes MIPS-eligible physicians only and not other health professionals.

The AGA and Alliance of Specialty Medicine sent a letter to Congress lobbying for increased flexibility. The AGA is meeting with several legislators to advocate for its proposals.

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