DHPA has submitted comments that propose ways to streamline the development and approval of Physician-Focused Payment Models (PFPMs) to the U.S. House Ways and Means Health Subcommittee’s Medicare Red Tape Relief Project. The new initiative is aimed at “delivering relief from the regulations and mandates that impede innovation, drive up costs, and ultimately stand in the way of delivering better care for Medicare beneficiaries.”
In announcing the Project earlier this summer, Ways and Means Health Subcommittee Chairman Pat Tiberi (R-OH) committed to reducing legislative and regulatory burdens on Medicare providers by working with doctors, nurses, and other health care professionals to identify opportunities to improve the efficiency and quality of the Medicare program for seniors and individuals with disabilities.
DHPA’s comments state that the Physician-Focused Payment Model Technical Advisory Committee (PTAC) should be given greater authority to design, develop and implement PFPMs. The letter also outlines concrete steps that can be taken to streamline regulations to create a meaningful and transparent role for PTAC in designing and implementing specialty-focused APMs. Specifically, DHPA urged the following metrics be developed to ensure the success of PTAC:
- A 90-day period for PTAC to review and decide whether to approve a proposed PFPM as an Advanced APM or MIPS APM, and to approve a certain number of PTAC-proposed PFPMs as Advanced APMs each year;
- Clearer guidance for clinicians in their development of PFPM proposals by publishing relevant, objective benchmarks that will be used by PTAC and CMMI to approve submitted models; and
- The application of a rebuttable presumption that, at a minimum, CMS will adopt any PFPMs approved by PTAC as MIPS APMs.
Click here to read DHPA’s full submission.