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History of the Medicare Access and CHIP Reauthorization Act (MACRA)

The “Medicare Access and CHIP Reauthorization Act” or “MACRA,” was signed into law on April 16, 2015. This bipartisan legislation permanently repeals the sustainable growth rate (SGR) formula and replaces Medicare’s multiple quality reporting programs with a new program that rewards physicians for providing high-quality, high-value health care.  In particular, physiatrists will need to be able to prove and articulate their value, which will mean identifying and defining optimal pathways or mechanisms for physiatric care, advocating for our patients, and producing data that proves our worth. 

The MACRA makes 3 important changes to how Medicare pays those who give care to Medicare beneficiaries. These changes include:

  1. Ending the Sustainable Growth Rate (SGR) formula for determining Medicare payments for health care providers’ services.
  2. Making a new framework for rewarding health care providers for giving better care not just more care.
  3. Combining our existing quality reporting programs into one new system.

View highlights of Medicare Access and CHIP Reauthorization Act of 2015 and learn more about the changes.

AAPM&R Responds 

On December 22, 2017, your Academy submitted comments in response to the CY 2018 Updates to the Quality Payment Program final rule. Your Academy thanked CMS for adding PM&R codes to QPP measure 182, Functional Outcomes Assessment, as the measure has been in our specialty measure set; however, physiatrist have never been able to use it until now. The letter also identified many unresolved challenges and reiterated previous recommendations made in our proposed rule comments that were not implemented into the final rule.