MACRA (Medicare Access and CHIP Reauthorization Act of 2015) basically repealed the SGR formula for determining Medicare Fee for Service payments. This act also included a replacement where Congress directed CMS to implement the Medicare Incentive Payment System (MIPS) as a new physician payment system that incentivizes quality and efficiency rather than volume. MIPS rolls the existing PQRS, Value Based Modifier and Meaningful Use into one program. The previous programs wer