CMS chief tells Senate panel MACRA delay possible, open to multiple start dates

"We understand new rules require adjustment and preparation," said Andy Slavitt, Centers for Medicare and Medicaid Services acting administrator.
By Beth Jones Sanborn
01:23 PM
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CMS Acting Administrator Andy Slavitt told a Senate Committee on Wednesday he undestood that small, rural physician practices would struggle with new MACRA rules.

Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt told the Senate Finance Committee Wednesday the agency would consider delaying the implementation of MACRA, the industry-overhauling bi-partisan legislation set to go into effect January 1 of next year.

In his testimony before the Committee, Slavitt conceded that small, rural and independent practices will struggle with the new rules, and a central theme emerging from the public comment period was the need to design a program with special consideration for these groups.

"They do not have the resources of larger groups and each new administrative requirement takes time away from patient care," Slavitt said.

[See also: CMS gets an earful on proposed MACRA changes from HIMSS, AMA, AMGA, others.]

He said another central theme from comments made asked that CMS look for flexibility to allow physicians and other clinicians and their communities time to learn about and prepare for the sweeping changes.

"We understand new rules require adjustment and preparation," Slavitt said.

As such, Slavitt said CMS is "open to multiple approaches", including alternative start dates, shorter reporting periods, and other ways for physicians and clinicians to get experience with the program before "the impact really hits them."

Right now, MACRA is slated for implementation on January 1 2017, with the final rules having been published around November 1, 2016. This means providers would only have 2 months from when the final rules are published until MACRA goes live in which to learn about them and understand how to engage with them.

The law does give CMS flexibility on start of reporting period, Slavitt said.

He also explained that the push is on to find ways to simplify the program and reduce reporting wherever possible so doctors can focus on patient care not paperwork. The use of automatic data feeds so physicians and clinicians don't have to report, as well as eliminating reporting in areas where they historically and consistently do well were two measures Slavitt threw out as being on the table.

Twitter: @BethJSanborn