DateSeptember 12, 2017
 
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PTAC Update: Secretary Responds to Proposals, Outcome of September Public Meeting and New Proposals Open for Comment

Secretary Responds to Proposals

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established the Physician-Focused Payment Model Technical Advisory Committee (PTAC) to review and assess physician-focused payment models (PFPMs) based on stakeholder proposals submitted to the committee. The Secretary of Health and Human Services (HHS) is required to review the comments and recommendations submitted by the PTAC and post a detailed response to these recommendations.

The Secretary recently posted comments on three proposals. Excerpts from their comments are below.

The ACS-Brandeis Advanced APM submitted by the American College of Surgeons

  • HHS agrees with PTAC that this proposal holds promise for testing but shares PTAC's concerns regarding the construct of the model
  • The proposal submitter is asked to address design concerns before HHS makes a final determination about testing this proposed model

The COPD and Asthma Monitoring Project submitted by Pulmonary Medicine, Infectious Disease and Critical Care Consultants Medical Group, Inc.

  • HHS agrees with PTAC that this proposal should not be tested
  • It does not plan to pursue models that mainly involve testing a particular form of proprietary technology or proposed models that are focused on implementation only by the submitter

Project Sonar submitted by the Illinois Gastroenterology Group and SonarMD, LLC

  • HHS acknowledges and shares PTAC's concerns regarding Project Sonar's payment methodology and care coordination approaches
  • It does not plan to pursue models that mainly involve testing a particular form of proprietary technology or proposed models that are focused on implementation only by the submitter
  • HHS requests that CMS reach out to the Illinois Gastroenterology Group and SonarMD, LLC to involve them in HHS' development of specialty models

 

Outcome of September Public Meeting

PTAC met September 7-8, 2017, in Washington, DC, to review three proposed payment models.  PTAC voting results are below.

HaH Plus” (Hospital at Home Plus) Provider-Focused Payment Model submitted by the Icahn School of Medicine at Mount Sinai

  • Outcome: Recommend for Implementation

Advanced Care Model (ACM) Service Delivery and Advanced Alternative Payment Model submitted by Coalition to Transform Advanced Care

  • Outcome: The Committee did not vote on this proposal; PTAC recommended that the submitter revise and resubmit the proposal

Oncology Bundled Payment Program Using CNA-Guided Care submitted by Hackensack Meridian Health and Cota, Inc.

  • Outcome: Recommend for Limited-scale Testing

PTAC will submit these recommendations to the Secretary who will make the final decision on which models to implement. A detailed response to the PTAC recommendations will be posted on the CMS Innovation Center website. Approved models will be implemented by the CMS Innovation Center.

 

New Proposals Open for Comment

PTAC is also soliciting comments until September 29, 2017 on two new proposals.

 

Comments should be addressed to the Designated Federal Officer for PTAC at PTAC@hhs.gov. Comments will be posted on the PTAC website approximately one week after the public comment period closes.

 

The McDermottPlus PTAC Proposal Tracker is available here.

 

McDermottPlus presentation on the PTAC proposal process is available here.

 


For more information on the CMS Quality Payment Program visit the McDermottPlus MACRA Resource Center or contact Sheila Madhani at 202-204-1459, smadhani@mcdermottplus.com.