The Centers for Medicare & Medicaid Services (CMS) is inviting comments on a proposed rule that would make 2018 a second transition year for the Quality Payment Program under MACRA. If finalized, it means that physicians need to earn 15 points in 2018 to avoid a negative Medicare Part B adjustment in 2020. Other highlights of the proposed rule are: it expands the low-volume threshold to $90,000 or less in Medicare Part B allowed charges or 200 or fewer Medicare Part B patients; physicians will not be scored on “resource use” (physician cost) in 2017; and it provides bonus points for treating complex patients. To read the entire proposed rule, go to You may post comments online by August 21 at If you need help with MACRA, please contact the ACCMA at (510) 654-5383.