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Roskam Opening Statement at Hearing on The Implementation of MACRA’s Physician Payment Policies

March 21, 2018

Washington, D.C. – House Ways and Means Health Subcommittee Chairman Peter Roskam (R-IL) today delivered the following opening statement at a Subcommittee hearing entitled “The Implementation of MACRA’s Physician Payment Policies.” MACRA is the Medicare Access and CHIP Reauthorization Act of 2015.

Click here to watch the hearing.

Remarks as prepared for delivery:

“Good afternoon everyone – let’s begin the hearing.

“For those of us who have been here for some time, it wasn’t too long ago that we were still living by one all too familiar deadline in health care, the annual, and sometimes semiannual, headache known as the ‘doc fix’.

“The Sustainable Growth Rate, or SGR was a failing payment model that was supposed to control costs in Medicare but in turn created payment uncertainty for doctors in Medicare that Congress acted to avert 17 times over the course of 15 years. Two years ago this committee came together in a bipartisan fashion, working with stakeholders and CMS, to craft the Medicare Access and CHIP Reauthorization or (MACRA). By consolidating the separate reporting requirements, and rewarding for higher quality care, we have begun to move toward a system that fully integrates value based care and places the proper incentives on high quality care.

“That is not to say the law is perfect. While in its intent the success of MACRA lines up with the success of the Medicare program and the move to value over volume.  Today we will hear from the Centers for Medicare and Medicaid Services, or CMS, on how the implementation of that intent is going, and whether or not we have learned lessons from the first two years after passage of MACRA.

“Several technical fixes to MACRA were included in the Bipartisan Budget Act that we passed in February. These changes grant greater flexibility and discretion to CMS as they continue to implement this new program to ensure that there are no unattainable goals that will prevent our doctors from succeeding if they are doing the right thing and avoid any ‘cliffs’ that will create a loss in faith in this blossoming new payment program.

“We also included a fix that would expand the responsiveness of the physician technical advisory committee, or PTAC, to stakeholders that have submitted ideas for alternative payment models.  APMs are foundationary to the intent of MACRA, that providers work together to create new, more efficient payment models that would result in better outcomes for patients.  So I hope that the PTAC, CMS, and the Innovation Center are all working together to maximize the amount of models available to our doctors in Medicare.

“We are holding this hearing as a continuation of our commitment to oversee proper implementation. That is the scope of this hearing – to discuss the implementation of MACRA and understand its role in the move to higher value, more patient centered care for our seniors. So I know that on a bipartisan basis, we are going to explore these issues. 

“Our role as Congress is to provide oversight, and in conjunction with CMS, continue to provide education on law is working for providers in Medicare.  As we explored at the last MACRA hearing – is CMS continuing to make sure that our small and individual practice providers have the opportunity to succeed under this program?

“We hope to continue to hear from stakeholders and work with CMS in implementing this law correctly, and ensure that we achieve the goal that I believe we all share, that MACRA work as intended.

“With that let’s get to it.”