Medicare Access and CHIP Reauthorization Act of 2015

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Medicare Access and CHIP Reauthorization Act of 2015
Great Seal of the United States
Long titleAn 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
NicknamesPermanent Doc Fix
Enacted bythe 114th United States Congress
Public lawPub.L. 114–10
Acts amendedSocial Security Act
Balanced Budget Act of 1997
Legislative history
  • Introduced in the House as H.R. 2 by Michael C. Burgess (R-TX) on March 24, 2015
  • Passed the House on March 26, 2015 (392–37)
  • Passed the Senate on April 14, 2015 (92–8)
  • Signed into law by President Barack Obama on April 16, 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 United States statute. It changes the payment system for doctors who treat Medicare patients. It revises the Balanced Budget Act of 1997. It was the largest scale change to the American health care system following the Affordable Care Act ("ObamaCare") in 2010.


MACRA's primary provisions are:[1]

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

Under MACRA, the Secretary of the Department of Health and Human Services (DHHS) is tasked with implementation of a Merit Based Incentive[2] (MIP), an incentive program that consolidates three incentive programs into one, for eligible physicians. The legislation allows for Advanced Alternative Payment Models[3] (APM). In 2026, the conversion factor for both programs will be set at 0.75%.

The Government Accountability Office in partnership with DHHS is set to assist in the implementation of nationwide electronic health records[2] (EHR), while simultaneously comparing and recommending such programs for providers; the EHR goal is set for December 31, 2018 under MACRA.[1]

The US 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). The new model will now require the provider to provide information on the quality of service being given, how valuable it is to the patient, and accountability that provider has to the treatment being performed.[4]



  1. ^ a b "Obama signs largest healthcare bill since Obamacare into law". RT. RT. Retrieved 2 August 2016.
  2. ^ a b H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015
  3. ^ "MACRA: MIPS & APMs". 7 August 2017.
  4. ^ "Are Your Ready for MACRA". 23 August 2017.

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