September 23, 2016

PTAC Establishes Review Process Timeline

The Physician-Focused Payment Model Technical Advisory Committee (PTAC), a key player in the definition of criteria for alternative payment models (APMs) as required by the Medicare Access and CHIP Reauthorization Act (MACRA), updated its draft review process and set a 16-week timeline for physician-focused payment model (PFPM) proposals at a Sept. 16 meeting.

The committee’s actions were based on comments received earlier this year in a Request for Information (RFI) as well as additional comments and board discussion at the meeting. The public comment period for the updated review process ends Oct. 10.

PTAC proposes to review proposal submissions on a rolling basis and will begin accepting proposal applications by Dec. 1. PTAC also proposes to recommend approved APMs to the Center for Medicare & Medicaid Innovation by spring 2017. In addition, the PTAC’s goal is to have PFPMs operational by 2018.

Below is the proposed review process timeline:

Phase I: Proposal Preparation and Submission

  • Letter of Intent: Stakeholders who are planning to submit a proposal to PTAC must submit a brief letter describing the nature of the proposal and the expected date of submission at least 30 days in advance of submitting a proposal.
  • Request for Proposals: Once criteria for PFPMs are established by the Secretary of the Department of Health and Human Services (DHHS), PTAC will issue a Request for Proposals (RFP).
  • Proposal Submission: Stakeholders may submit proposals following issuance of the RFP.
  • Review of Proposals for Completeness and Adherence to RFP Requirements: Upon receipt of a proposal, PTAC will determine whether the proposal contains the information required by the RFP.
  • Identification of and Remedies for Conflicts of Interest and Lack of Impartiality: PTAC members with conflicts of interest or a lack of impartiality related to a proposal will be identified and remedies determined.
Phase II: Preliminary Review

  • Formation of Preliminary Review Team: A proposal that contains the information required by the RFP will be assigned to a preliminary review team consisting of a subgroup of PTAC members.
  • Preliminary Review of Proposal: A report containing findings regarding the proposal and a draft recommendation for discussion by PTAC will be developed by the preliminary review team.
Phase III: Full Committee Review

  • Public Meeting Deliberation and Recommendation: PTAC will decide on its recommendation regarding a proposal during a public meeting.
  • Follow-Up on PTAC Decisions: PTAC will submit its comments and recommendations to the DHHS Secretary and make them available to the public.
PTAC was authorized by MACRA to make recommendations to the DHHS Secretary on the creation, development and operation of PFPMs. Its 11-member board, appointed by the U.S. Comptroller General, is comprised of physicians and national health care policy experts. Use this LINK to the DHHS Office of the Assistant Secretary for Planning and Evaluation to learn more about PTAC.