• 10/12/2017 4:59 PM | Rebekah Francis (Administrator)

    The Independent Payment Advisory Board (IPAB) could finally be coming to an end. Last week, the House Ways and Means Committee approved bipartisan legislation (H.R. 849) to repeal the IPAB, a cost containment tool mandated by the Affordable Care Act to convene if Medicare spending exceeds a specified liimit. The IPAB has significant power to make changes to Medicare spending, leaving little-to-no room for recourse if IPAB-mandated payment cuts are triggered.

    It is paramount that Congress act now and pass this important legislation before future actuary reports trigger the IPAB and activate payment reductions to Medicare providers. Contact your member of Congress now via MGMA's Advocacy Center and urge lawmakers to support this important legislation.

  • 10/12/2017 4:59 PM | Rebekah Francis (Administrator)

    CMS released a new tool that allows clinicians and practices to look up whether they achieved qualified participant (QP) status in an Advanced APM for the 2017 performance year based on claims data with dates of service from January through March. As a reminder, those who achieve QP status in 2017 are eligible for a 5% lump sum bonus and exempt from MIPS in 2019. Clinicians who did not qualify during the first claims analysis will have two more opportunities to achieve QP status this year based on claims data from April through June and July through August. For more information visit MGMA's APM resource center.

  • 10/05/2017 10:42 AM | Rebekah Francis (Administrator)

    After an aggressive advocacy effort by MGMA, CMS released guidance on the issues of Electronic Funds Transfer (EFT) payments and the use of “virtual” credit cards (VCCs). Health plans sending VCCs must stop if a provider requests to receive payments via EFT. Most importantly, health plans (or their payment vendors) must not charge providers unsanctioned fees for the use of EFT. Permissible fees are limited to banking fees, typically around $.034 per transaction. In addition, practices are not required to contract for additional “value added” payment services from vendors and signing up for EFT does not automatically allow the plan to deduct funds from a provider’s account unless contractually authorized by the provider to do so. Access the MGMA member-benefit EFT/ERA Guide for more information and our sample letter to request payment via EFT.

  • 10/05/2017 10:41 AM | Rebekah Francis (Administrator)

    MGMA joined the American Medical Association and more than 100 physician specialty and state medical organizations in a letter urging Congress to ensure smooth implementation of Medicare payment policies under the Medicare Access and CHIP Reauthorization Act (MACRA). In particular, MGMA and the medical community call for a three-year extension of program flexibility to ensure physician practices are able to successfully participate in the new Merit-Based Incentive Payment System (MIPS) while CMS finalizes cost measures, improves data feedback, and provides tools to improve performance. Among other refinements, the letter requested clarification that Medicare Part B drugs are outside the scope of MIPS payment adjustments.

  • 10/05/2017 10:40 AM | Rebekah Francis (Administrator)

    MGMA offered recommendations to reduce unnecessary government regulations at the U.S. Department of Health and Human Services (HHS) “Cut the Red Tape” Summit this week. During their opening remarks, HHS Acting Secretary, Dr. Don Wright, CMS Administrator, Seema Verma, and other HHS officials reiterated the Department’s commitment to reducing excessive regulatory burdens on medical group practices. During the panel discussion, Anders Gilberg, MGMA’s Senior Vice President of Government Affairs, shared results from MGMA’s 2017 Regulatory Burdens survey that highlighted the considerable time and resources required to comply with federal mandates and identified key areas of concern for medical group practices, such as the lack of clinical relevance in Medicare’s Quality Payment Program. MGMA will continue to call on HHS to support innovative, high-quality, and cost-effective care delivery untethered from excessive, one-size-fits-all regulations. 

  • 10/05/2017 10:39 AM | Rebekah Francis (Administrator)

    The Centers for Medicare & Medicaid Services (CMS) withdrew its proposal to change the way Medicare pays for drugs administered in physician offices. MGMA raised significant concerns regarding the proposed payment model, which would have reduced Medicare reimbursement without addressing the root cause of drug price increases set by the manufacturer. The Association also took issue with the fact that this mandatory model would establish a precedent under which the CMS Innovation Center could expand its limited legislative authority to circumvent the usual channels for changing physician payment. MGMA continues to recommend the agency seek physician practice input in developing payment models to support innovative approaches to improve quality and affordability without restricting patient access to life-saving treatments.

  • 09/27/2017 4:00 PM | Rebekah Francis (Administrator)

    The latest Affordable Care Act (ACA) replacement proposal will not be brought to a vote in the Senate, after Susan Collins, R-ME, became the third Republican to publicly come out against it. MGMA expressed concerns over this latest proposed Senate bill based on our healthcare reform principles. The Senate appears willing to resume its own bipartisan efforts to stabilize the exchanges for next year.

  • 09/27/2017 3:58 PM | Rebekah Francis (Administrator)

    Group practices and eligible clinicians (ECs) seeking to earn a bonus in the Merit-Based Incentive Payment System (MIPS) in 2019 have until Oct. 2 to begin reporting one or more quality measures, improvement activities, or Advancing Care Information measures for the minimum 90 consecutive days. Conversely, group practices and ECs have through the end of the calendar year to avoid a 4% MIPS penalty in 2019 by reporting at least one quality measure on one patient. MGMA encourages practice executives to protect their practice from a Medicare payment cut by reporting more than one measure as an insurance policy in case the group encounters any data submission issues or inaccuracies. For resources to help your practice successfully participate in MIPS, visit

  • 09/18/2017 3:26 PM | Rebekah Francis (Administrator)

    MGMA submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the proposed 2018 Medicare physician fee schedule. The proposed rule includes a number of policies that, if finalized, would affect medical group practices in 2018.

    Among its recommendations, MGMA advocates for CMS to: 

    • Finalize the proposed delay in requiring appropriate use criteria consultation and documentation; 
    • Hold medical groups harmless from 2018 penalties in the obsolete PQRS, Meaningful Use, and Value Modifier programs if they reported some data in 2016; and
    • Reduce unnecessary regulations and improve the quality and efficiency of healthcare delivery using the results of MGMA 2017 Regulatory Burdens survey as a compass. 

    Gain insight about the impact of Medicare payment policies on your practice at MGMA17 in Anaheim. MGMA government affairs presentations will highlight legislative and regulatory issues critical to your groups success, feature exclusive office hours with CMS Director of the Center for Clinical Standards and Quality, Dr. Kate Goodrich, and culminate in the popular View from Washington general session with MGMAs Senior Vice President of Government Affairs. Register today to secure your spot.

  • 09/18/2017 3:25 PM | Rebekah Francis (Administrator)

    A Sept. 5 MGMA Stat poll found that about 1 out of 6 practices report that their health plans charge transaction fees, typically ranging from 2-5%, to receive payments for medical services via Electronic Funds Transfer (EFT). As part of an effort in the Affordable Care Act to decrease healthcare administrative inefficiencies, CMS mandated a standardized EFT transaction and since 2014 health plans are required to offer EFT should providers request it. Contrary to the intent of the law, and despite the fact that health plans themselves save on printing and mailing costs, many practices are required to pay these EFT tolls. MGMA continues to strongly advocate that CMS issue guidance preventing health plans and payment vendors from charging these fees. Review the MGMA member-benefit EFT and ERA Guide.


To develop and equip our members to create dynamic, successful medical group practices.


To be the recognized leader in defining and supporting the profession of medical practice management in Missouri.


PO Box 381533
Birmingham, AL 35238
Phone: (573) 556-6111
Fax: (877) 720-1495

Copyright 2022, |