Medicare Access and CHIP Reauthorization Act of 2015

Medicare Access and CHIP Reauthorization Act of 2015
Short title	Medicare Access and CHIP Reauthorization Act of 2015
Long title	An Act to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and strengthen Medicare access by improving physician payments and making other improvements, to reauthorize the Children's Health Insurance Program, and for other purposes
Enacted by	114th United States Congress
Enacted date	April 16, 2015
Signed by	Barack Obama
Signed date	April 16, 2015
Effective date	Various

Medicare Access and CHIP Reauthorization Act of 2015 is a federal law that was enacted to reform the payment system for Medicare physicians and to extend funding for the Children's Health Insurance Program (CHIP). The law was signed by President Barack Obama on April 16, 2015, after being passed by the 114th United States Congress with bipartisan support from Republican and Democratic lawmakers, including John Boehner, Nancy Pelosi, and Mitch McConnell. The law aims to improve the quality of care for Medicare beneficiaries and to reduce costs for the program, while also providing funding for CHIP and other healthcare programs, such as Community Health Centers and the National Health Service Corps.

Introduction

The Medicare Access and CHIP Reauthorization Act of 2015 was introduced in response to concerns about the sustainable growth rate (SGR) formula, which was used to determine payments to Medicare physicians. The SGR formula had been criticized for being flawed and for leading to significant cuts in payments to physicians, which could have resulted in access problems for Medicare beneficiaries, as noted by American Medical Association and American Hospital Association. The law replaces the SGR formula with a new payment system, known as the Quality Payment Program, which is designed to reward high-quality care and to improve patient outcomes, as recommended by Institute of Medicine and National Academy of Medicine. The law also extends funding for CHIP and other healthcare programs, such as Health Resources and Services Administration and Substance Abuse and Mental Health Services Administration.

Legislative History

The Medicare Access and CHIP Reauthorization Act of 2015 was passed by the United States House of Representatives on March 26, 2015, with a vote of 392-37, and by the United States Senate on April 14, 2015, with a vote of 92-8. The law was supported by a number of healthcare organizations, including the American Medical Association, American Hospital Association, and America's Health Insurance Plans, as well as by patient advocacy groups, such as AARP and American Cancer Society. The law was also endorsed by Centers for Medicare and Medicaid Services and Department of Health and Human Services.

Provisions

The Medicare Access and CHIP Reauthorization Act of 2015 includes a number of provisions designed to improve the quality of care for Medicare beneficiaries and to reduce costs for the program. The law replaces the SGR formula with the Quality Payment Program, which provides incentives for physicians to provide high-quality care, as outlined by Centers for Medicare and Medicaid Services and National Committee for Quality Assurance. The law also extends funding for CHIP through 2017 and provides funding for other healthcare programs, such as Community Health Centers and the National Health Service Corps, which are supported by Health Resources and Services Administration and Substance Abuse and Mental Health Services Administration. Additionally, the law includes provisions to improve the Medicare appeals process and to reduce the administrative burden on healthcare providers, as recommended by Medicare Payment Advisory Commission and Office of the Inspector General (US).

Impact on Healthcare

The Medicare Access and CHIP Reauthorization Act of 2015 is expected to have a significant impact on the healthcare system, particularly for Medicare beneficiaries and CHIP recipients, who are served by Centers for Medicare and Medicaid Services and State Children's Health Insurance Program. The law's replacement of the SGR formula with the Quality Payment Program is expected to improve the quality of care for Medicare beneficiaries and to reduce costs for the program, as noted by Congressional Budget Office and Medicare Trustees. The law's extension of funding for CHIP will also ensure that millions of children and families continue to have access to healthcare coverage, as reported by Centers for Disease Control and Prevention and National Association of Children's Hospitals. Furthermore, the law's provisions to improve the Medicare appeals process and to reduce the administrative burden on healthcare providers will help to streamline the healthcare system and reduce costs, as recommended by American Medical Association and American Hospital Association.

Implementation and Timeline

The Medicare Access and CHIP Reauthorization Act of 2015 was implemented in several phases, with different provisions taking effect at different times. The law's replacement of the SGR formula with the Quality Payment Program took effect on January 1, 2017, as outlined by Centers for Medicare and Medicaid Services and Department of Health and Human Services. The law's extension of funding for CHIP took effect on October 1, 2015, and will continue through 2017, as reported by Congressional Budget Office and Medicare Trustees. The law's provisions to improve the Medicare appeals process and to reduce the administrative burden on healthcare providers took effect on various dates, as recommended by Medicare Payment Advisory Commission and Office of the Inspector General (US).

Criticisms and Controversies

The Medicare Access and CHIP Reauthorization Act of 2015 has been subject to some criticisms and controversies, particularly from Republican lawmakers who opposed the law's funding mechanisms, including Paul Ryan and Mitch McConnell. Some lawmakers have also expressed concerns about the law's impact on Medicare beneficiaries and CHIP recipients, as noted by AARP and American Cancer Society. Additionally, some healthcare organizations have raised concerns about the law's administrative burden and the complexity of the Quality Payment Program, as reported by American Medical Association and American Hospital Association. Despite these criticisms, the law has been widely supported by healthcare organizations and patient advocacy groups, including Centers for Medicare and Medicaid Services and Department of Health and Human Services.

Category:United States federal healthcare legislation