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The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a federal Act that determines the way in which physicians need to be paid when they treat patients who come to them under Medicare. It substantially alters and replaces the earlier Act in this regard, namely the Balanced Budget Act, which was in force from 1997. Signed into law by then president Barack Obama; MACRA is hailed as his biggest step at reforming the healthcare system in the US since the Affordable Care Act or Obamacare of five years earlier.
What MACRA does is that it does away with the provisions for physician payments that existed earlier, which was considered flawed as it linked physician payments to budget cuts and economic growth, as a result of which physicians were receiving a 21 percent decrease in their payments. MACRA replaces it with “pay-for-performance” programs called Merit based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APM's).
Brings about reforms in CHIP
Apart from fixing the way doctors are reimbursed under Medicare; MACRA also extends the State Children's Health Insurance Program, later christened as just CHIP, short for Children's Health Insurance Program. Under the CHIP reauthorization provision of this law, around eight million children from low-income groups will receive coverage for two years from the date of this legislation. It also brings into its fold children whose families earn a little more than needed to qualify for Medicaid benefits by providing them low cost health insurance coverage.
Seeks to reform healthcare funding, as well
MACRA also seeks to fill lacunae in the healthcare funding system by requiring higher income beneficiaries to pay higher premiums for their healthcare from 2018. It fixes slabs of premiums that people in different higher income categories have to pay, based on their income.
Also, starting in 2020, MACRA will prohibit insurers from selling supplementary insurance to new beneficiaries with the intention of covering the costs that accrue on doctor services in Medicare deductible.
The practical ways of implementing MACRA have to be learnt
While all these changes are being sought into MACRA; understanding how to implement it is complex. The law requires strict compliance with its provisions. This is something that only proper and professional trainings can impart.
This is exactly what a webinar that is being organized by MentorHealth, a leading provider of professional trainings for the healthcare industry, will be offering. At this webinar, Brian Tuttle, a healthcare professional with over 15 years’ experience in Health IT and Compliance Consulting, will be the speaker. To understand the deeper aspects of how to implement MACRA; please enroll for this webinar by visiting http://www.mentorhealth.com/control/w_product/~product_id=800991/?m...
The link between MACRA and HIPAA compliance
In particular, Brian will focus on the core importance of HIPAA to MACRA and how the two relate to each other. He will explain how to actually “prove” compliance with HIPAA.
Since the government is very stringent on all aspects of HIPAA implementation including in relation to MACRA; Brian will delve into how practice managers or compliance offers need to understand and implement HIPAA. He will pepper the presentation with specific examples of litigated cases that he has been involved with in which HIPAA violations led to prosecution under state laws of negligence. Also offered in the presentation are specifics relating to HIPAA, which has been gleaned from his experience of having worked both with and against the Federal government in multiple HIPAA audits from 2016.
In the course of this discussion, which will be of tremendous value to practice managers and medical professionals of various specializations; Brian will cover the following areas:
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