PTAC Accepts Comments on Draft RFP and PFPM-related Guidance Until October 14

The Physician-Focused Technical Advisory Committee (PTAC) is accepting comments until October 14, 2016, on a draft Request for Proposals (RFP) for physician-focused payment models (PFPMs) and draft guidance on characteristic of payment models likely to be recommended by PTAC.

Draft RFP: The draft RFP indicates that any individual or organization may submit a proposal. PTAC is proposing to require a letter of intent to be submitted at least 30 days prior to the proposal, a page limit of 20 pages (although appendices for additional information are allowed and do not count towards the page limit) and the proposal would need to be submitted at least 14 weeks in advanced of a PTAC public meeting. Submitters would be required to provide an overview of the model and a narrative describing how the payment model meets the PFPM criteria proposed by the Centers for Medicare and Medicaid Services.

PTAC states they plan on providing public education sessions and informational materials, such as webinars and FAQs, regarding the requirements of the RFP and the proposal review process. PTAC will also make available technical papers on topics such as accessing data.

The draft RFP can be downloaded here.

Characteristics of Payment Models Likely to be Recommended by PTAC: PTAC also released for comment a draft guidance as to the kinds of payment models that are more likely to receive favorable recommendations. While in general the document reflects many of the big picture concepts found in the CMS’s proposed criteria of PFPMs, the document also provides more practical guidance. For example, the document states that “PTAC will be unlikely to recommend a proposed PFPM if the only change it makes is to give a physician the ability to bill for a single type of service that is not currently eligible for payment under the Physician Fee Schedule.” It also indicates that if a proposed payment model impacts both physicians and hospitals, “the PTAC will be more likely to recommend the model as a PFPM if a substantial portion of the payment supports services that are delivered or ordered by physicians.”

The draft guidance document can be downloaded here.

As previously reported by McDermottPlus, PTAC recently announced that they anticipate accepting PFPM proposals beginning December 1, 2016.

Established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), PTAC is tasked with providing comments and recommendations to CMS on physician payment models. The Committee includes 11 members who are nationally recognized for their expertise in physician-focused payment models and related delivery of care. More information on PTAC is available on their website.

More information on MACRA can be found at the McDermottPlus MACRA Resource Center.