Medicare Access and CHIP Reauthorization Act of 2015

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), (H.R. 2, Pub.L. 114–10) commonly called the Permanent Doc Fix, is a law that establishes a new way to pay doctors who treat Medicare patients, revising the Balanced Budget Act of 1997. It reform is the largest in scale on the American health care system since the Affordable Care Act ("ObamaCare") in 2010. It changes the way Medicare doctors are reimbursed, fills in a funding gap and extends a popular children's insurance program, CHIP.

MACRA related regulations also address incentives for use of health IT by physicians and other care providers.

Under MACRA, the Secretary of the Department of Health and Human Services (DHHS) is tasked with implementation of a Merit Based Incentive (MIP) an incentive program which consolidates the three existing incentive programs into one for eligible physicians. The legislation also allows for Advanced Alternative Payment Models (APM) in 2026 the conversion factor for both programs will be set at 0.75% followed by each subsequent year.

The Government Accountability Office in partnership with the DHHS are set to assist in the implementation of nationwide electronic health records (EHR), while simultaneously comparing and selecting of such programs for providers; the EHR goal is set for December 31, 2018 under MACRA.

The U.S. is set to transition from a fee for service system, which allowed physicians and providers to bill Medicare and Medicaid for services they provided to their patients, to a pay for performance based system using MIP, APM, and Accountable Care Organizations (ACO).