04.16.15

President Signs Permanent ‘Doc-Fix’ Bill that Incorporates Cantwell-authored Reform

Senator applauds Medicare Access and CHIP Reauthorization Act, which builds on Value Based Modifier provision

WASHINGTON, D.C. – Today, President Obama signed into the law the Medicare Access and CHIP Reauthorization Act, which reforms the way Medicare pays physicians by building on a provision Senator Maria Cantwell (D-WA) authored that is based on the quality of care rather than the volume of services.

The bill incorporates Cantwell’s Medicare Value Based Modifier into a new “Merit-Based Incentive Payment System (MIPS)” that will start in 2019.  The new system bases physician payments on a composite score of four factors, including quality, efficiency, clinical practice improvement, and use of electronic health records. It scores physicians on performance, rewarding high performers with a bonus.

“Today’s action by President Obama is a positive step forward to a more efficient health care system that delivers better results for patients and lower costs for taxpayers,” Cantwell said. “Incorporated in the bill is my Value-Based Modifier, which seeks to emulate successes in Washington and other innovative states, where we commonly get better health outcomes at a much lower cost. I hope the Value Based Modifier will serve as a catalyst for ensuring Medicare values efficiency and quality in the way it pays for physician care.”

The Senate passed the legislation Tuesday on a 92-8 vote. The bill passed the House on March 26.

The legislation permanently repeals the Sustainable Growth Rate – the current formula for determining annual updates to Medicare physician payments. 

The bill also extends funding for the Children’s Health Insurance Program (CHIP) and other expiring health care programs for two years.  Cantwell supported an amendment that would have extended funding to the CHIP program for four years.  Also included in the bill is a Cantwell-authored provision requiring the Secretary of Health and Human Services to study the feasibility of integrating alternative payment models into the Medicare Advantage system.

Cantwell has led efforts to reform the Medicare reimbursement system and authored the Medicare Value Based Modifier as part of the Affordable Care Act of 2010.

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