American Society of Plastic Surgeons
For Consumers

Congress: Fix MACRA Before 2020

Since 2015, ASPS has warned Congress about the negative ramifications of provisions within the Medicare and CHIP Access and Reauthorization Act (MACRA). Given the complexity of the law and implications that the Medicare fee schedule has on plastic surgeons, the Society has remained regularly engaged with Congress and the Centers for Medicare Services (CMS) to ensure that Medicare-participating physicians receive fair reimbursement for their services.

In September, ASPS submitted comments to congressional leadership urging them to make additional enhancements to MACRA before the end of the calendar year to ensure that Medicare reimbursement keeps pace with the true market dynamics of providing specialty care to the nation's aging population. Unfortunately, starting in January 2020, Medicare-participating physicians will see no positive payment update to the Physician Fee Schedule for six years. Physician costs are expected to increase 2.2 percent annually over the next few years according to the 2019 Medicare Trustees Report, which is why ASPS urged lawmakers to remove this payment freeze and ensure that Medicare reimbursement keeps pace with inflation.

Additionally, the Society encouraged Congress to make meaningful reforms that would allow specialty physicians to more actively participate in the Quality Payment Program (QPP). While a vast majority of plastic surgeons currently participate in the Merit-Based Incentive Payment System (MIPS), this payment pathway needs to be strengthened by ensuring that the scoring components place a greater priority on quality outcomes of care and recognize the distinction between specialty and primary care services. The Society also encouraged Congress to put pressure on CMS to approve additional Advanced Alternative Payment Models (A-APMs) for specialty care so plastic surgeons have the opportunity to transition to this new payment model as another alternative to MIPS.

Earlier this summer, ASPS joined 120 other medical societies in signing onto a coalition-led letter by the American Medical Association that delivered a similar message to Congress about the need to make technical updates to the law. One month later, during the Alliance of Specialty Medicine Fly-In, ASPS President-Elect Lynn Jeffers, MD joined specialty doctors in requesting a viable Medicare Fee-For-Service Option during meetings with members of Congress on Capitol Hill. As the 2019 legislative session comes to an end, ASPS will continue to work with these coalition partners to encourage Congress to include a MACRA fix in any end-of-the-year spending package.