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HEARING: Chairman Tiberi Opening Statement at Health Subcommittee Hearing on MACRA Implementation

May 11, 2016

WASHINGTON, D.C. – House Ways and Means Health Subcommittee Chairman Pat Tiberi (R-OH) delivered the following opening statement at a Subcommittee hearing entitled “Implementation of Medicare Access & CHIP Reauthorization Act of 2015 (MACRA).”

Remarks as prepared for delivery:

“I am very excited to finally be having this hearing. When I came to Congress back in 2001, the Sustainable Growth Rate, or SGR, provision in BBA 97 was in the process of being implemented. Under this payment formula, any yearly increase in per beneficiary spending that exceeded growth in GDP could result in a negative adjustment for physician payment in Medicare. Clearly this policy – or the math – didn’t work, and for the next 15 years, we had almost yearly struggles over what was aptly named the “doc fix.” Seventeen of these “doc fixes” later takes us to last March, when we came together in a bipartisan fashion, with stakeholder input and CMS technical support to pass the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA, with nearly 400 votes. This legislation finally put an end to the sustainable growth rate so that doctors could focus on patient care – not worry about unpredictable payments.

“We have called this hearing today to take our first look at the regulations released by CMS on April 27th. We will look closely at how these regulations match up with Congressional intent and what our Members and CMS are hearing from stakeholders as they digest the 950 plus pages of regulation. That is the scope of this hearing– to discuss the implementation of this truly historic legislative feat. And there is a lot in the proposed rule to discuss, so I know that on a bipartisan basis, we are going to dive in.

“Furthermore, I would like to take a moment to encourage Members on both sides of the aisle, as you hear from stakeholders and constituents regarding concerns or other thoughts, to bring them to the attention of bipartisan Committee staff so that we can continue to do robust oversight and keep CMS up to date on that information as they formulate the final regulation.

“The passage of MACRA last year confirmed our commitment, on both sides of the aisle, to keep Medicare strong for America’s seniors. This is important to me, especially after we just celebrated Mother’s Day, as both my parents back in my district in Ohio depend on the Medicare program. By replacing the way that physicians are paid and consolidating the separate quality measurement systems, we have taken a great step towards the ultimate goal of fully integrated value-based care through the incentivization of high quality care.

“Now our role as Congress is to provide oversight, and in conjunction with CMS, to provide education on how this new law will work for the various types of clinicians and provider groups. We need to answer how this rule will affect individual and small group providers versus larger groups; How will this rule affect specialty groups, versus primary care physicians? How will the timing work for implementation under some potentially tight timelines? These are questions that I hope to get clarity on today and going forward through the implementation process.

“As we move forward with implementation, I want to make sure that we as a Congress recognize some very important facts regarding the law that we passed. The Merit-based Incentive Payment System, or MIPS, is and was created as a budget neutral program. High quality, value based care will take effort, but as I said before, such efforts must be recognized within environmental and timing factors based in reality. Additionally, the thresholds for providers to qualify as Advanced Alternative Payment Models are high, and are set in statute.

“Working on a bipartisan basis, with stakeholders from every corner of America and an open dialogue and cooperation from CMS, will allow us to follow MACRA into the next generation of value based health care. Now with that let’s get to work.”