On April 16, President Barack Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), legislation which permanently repeals the Sustainable Growth Rate (SGR), establishes a framework for rewarding clinicians for value over volume, streamlines quality reporting programs into one system, offers new opportunities for nurse practitioners, and reauthorizes two years of funding for the Children's Health Insurance Program. The bill (H.R. 2) does not require participation in maintenance of certification (MOC), nor does it establish the American Board of Medical Specialties, the American Board of Internal Medicine or any specific entity to administer MOC. No one will be forced to participate in MOC.

The Senate passed H.R. 2 in a 92-8 vote earlier in the week. Both Democrat and Republican senators offered amendments airing concerns with the legislation, but all failed and the bill remained intact. This allowed for MACRA's clean passage through the chamber.

"Today is an exceptional day for Medicare patients and for the medical professionals who care for them, thanks to the long-awaited permanent repeal of the flawed Sustainable Growth Rate formula, said ACC President Kim Allan Williams, Sr., MD, FACC, following the Senate vote. "The Senate has accomplished a major feat by passing legislation that ends a cycle of delays and patches in the law, which has created uncertainty for Medicare patients and clinicians for more than a decade. Through the crafting and passage of MACRA, Congress has proven it can take bipartisan, bicameral action to solve seemingly insurmountable problems. We applaud the members in the House and Senate for coming together to implement true Medicare reform while extending funding for the Children's Health Insurance Program, which offers access to health care for many children, including those with complex cardiovascular conditions."

The SGR and the perpetual instability it created is officially a concern of the past, meaning clinicians can now focus on providing high quality, patient-centered care unburdened by the looming threat of payment cuts. ACC's member leaders have played an enormous role in this achievement, participating in years' worth of meetings with lawmakers and responding to countless alerts to educate Congress on the topic. In this final push alone, ACC members sent over 7,500 messages to Congress urging them to pass this bill. With this threat off the table, we can now turn our attention to the important work of bringing our health care delivery system into a new era.

Get a detailed summary of MACRA and how it will impact you and your practice.

Keywords: Delivery of Health Care, Insurance, Health, Medicare, Health Services Accessibility, Medicare Access and CHIP Reauthorization Act of 2015

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