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Note: An Annual Comprehensive Review, as required by §7 of the Federal Advisory Committee Act, is conducted each year on committee data entered for the previous fiscal year (referred to as the reporting year). The data for the reporting year is not considered verified until this review is complete and the data is moved to history for an agency/department. See the Data From Previous Years section at the bottom of this page for the committee’s historical, verified data.


HHS - 2559 - Physician-Focused Payment Model Technical Advisory Committee - Statutory (Congress Created)
Hide Section - GENERAL INFORMATION

GENERAL INFORMATION

Committee NamePhysician-Focused Payment Model Technical Advisory CommitteeAgency NameDepartment of Health and Human Services
Fiscal Year2020Committee Number2559
Original Establishment Date1/5/2016Committee StatusChartered
Actual Termination Date Committee URLhttps://aspe.hhs.gov/ptac-physician-focused-pay...
New Committee This FYNoPresidential Appointments*No
Terminated This FYNoMax Number of Members*11
Current Charter Date1/5/2016Designated Fed Officer Position Title*DFO
Date Of Renewal Charter Designated Federal Officer Prefix
Projected Termination Date Designated Federal Officer First Name*Stella
Exempt From Renewal*YesDesignated Federal Officer Middle Name
Specific Termination AuthorityDesignated Federal Officer Last Name*Mandl
Establishment Authority*Statutory (Congress Created)Designated Federal Officer Suffix
Specific Establishment Authority*42 U.S.C. §1395ee(c)(1)Designated Federal Officer Phone*(202) 205-6576
Effective Date Of Authority*4/16/2015Designated Federal Officer Fax*202-401-7589
Exempt From EO 13875 Discretionary CmteNot ApplicableDesignated Federal Officer Email*stella.mandl@hhs.gov
Committee Type*Continuing
Presidential*No
Committee Function*National Policy Issue Advisory Board
Hide Section - RECOMMENDATION/JUSTIFICATIONS

RECOMMENDATION/JUSTIFICATIONS

Agency Recommendation*Continue
Legislation to Terminate Required 
Legislation Status 
How does cmte accomplish its purpose?*The establishing statute requires the Physician-Focused Payment Model Technical Advisory Committee (PTAC) to review physician-focused payment model (PFPM) proposals submitted by individuals and stakeholder entities and make comments and recommendations to the Secretary of Health and Human Services (HHS) regarding the extent to which such models meet criteria established by the Secretary. In FY 20 the Committee delivered comments and recommendations to the Secretary on 3 proposals. It will continue to review proposals and send comments and recommendations to the Secretary in future fiscal years on an ongoing basis.
How is membership balanced?*The establishing statute requires that the Comptroller General of the United States appoint PTAC members.
How frequent & relevant are cmte mtgs?*The number of PTAC meetings per year are influenced by the number of proposals that PTAC receives from individual and stakeholder entities. However, PTAC aims to meet quarterly.
Why advice can't be obtained elsewhere?*The establishing statute requires PTAC, whose membership must include individuals with national recognition for their expertise in PFPMs and related delivery of care, to review PFPM proposals submitted by individuals and stakeholder entities and make comments and recommendations to the Secretary regarding the extent to which such models meet criteria established by the Secretary.
Why close or partially close meetings?N/A
Recommendation RemarksPTAC members who reside locally, as per federal travel regulations, are only reimbursed local travel expenses (e.g., mileage and parking). They do not receive a per diem reimbursement. This is why these some PTAC members' pay plan is listed as "Other". The designation for all members is listed as "Ex Officio" due to the absence of an "Other" category. It has been determined that PTAC members are neither special government employees nor representatives. Cost calculations vary from prior years. Contracts are included under payments to consultants if the contract included technical support. Performance measures also vary from prior years. Performance measures include cumulative totals for the life of PTAC as of FY20. In FY 20, of the 4 scheduled meetings, one of the meetings was cancelled due to COVID/travel restrictions and one was cancelled because a key member was unable to join due to an unforeseen scheduling conflict. In FY 20 there was an uptick in recommended full and partial implementations.
Hide Section - PERFORMANCE MEASURES

PERFORMANCE MEASURES

Outcome Improvement To Health Or Safety*YesAction Reorganize Priorities*No
Outcome Trust In GovernmentYesAction Reallocate ResourcesNo
Outcome Major Policy ChangesYesAction Issued New RegulationsNo
Outcome Advance In Scientific ResearchNoAction Proposed LegislationNo
Outcome Effective Grant MakingNoAction Approved Grants Or Other PaymentsNo
Outcome Improved Service DeliveryYesAction OtherNo
Outcome Increased Customer SatisfactionYesAction CommentN/A
Outcome Implement Laws/Reg RequirementsYesGrants Review*No
Outcome OtherNoNumber Of Grants Reviewed0
Outcome CommentNumber Of Grants Recommended0
Cost Savings*Unable to DetermineDollar Value Of Grants Recommended$0.00
Cost Savings CommentCost savings will depend upon how many PFPM proposals PTAC receives, the nature of those proposals, how many PTAC recommends to the Secretary, and the outcomes of testing of models by HHS.Grants Review Comment
Number Of Recommendations*26Access Contact Designated Fed. Officer*Yes
Number Of Recommendations CommentIn FY 20, PTAC delivered comments and recommendations to the Secretary on 3 PFPM proposals. In FY 19, PTAC delivered comments and recommendations to the Secretary on 8 PFPM proposals. In FY 18, PTAC delivered comments and recommendations to the Secretary on 12 PFPM proposals. In FY 17, PTAC delivered comments and recommendations to the Secretary on 3 PFPM proposals.Access Agency WebsiteYes
% of Recs Fully Implemented*23.07%Access Committee WebsiteYes
% of Recs Fully Implemented CommentAs of FY 20, PTAC has delivered comments and recommendations to the Secretary on 26 proposals. PTAC did not recommend 6 proposals and determined the Secretary’s criteria are not applicable to 2 proposals. PTAC recommended 2 proposals for attention, 8 for limited-scale testing, 2 for testing to inform payment model development, 1 for further development and implementation as a payment model, and 5 for implementation. The Secretary has responded to PTAC’s comments and recommendations on 24 of these proposals. (Secretarial responses to 2 proposals – 1 that was not recommended and 1 that was recommended for attention– are pending). Secretarial responses agreed with PTAC’s findings on 5 proposals that were not recommended or where the Secretary’s criteria were deemed not applicable. The Secretarial responses did not commit to implementation or testing of any of the proposed PFPMs as recommended by PTAC, and development and implementation takes time.Access GSA FACA WebsiteYes
% of Recs Partially Implemented*69.23%Access PublicationsYes
% of Recs Partially Implemented CommentThe Secretarial responses for many of the proposals reflect interest in exploring how proposed ideas might inform model development and/or a desire to continue to engage stakeholders. HHS leaders have also publicly acknowledged that aspects of proposals submitted to and reviewed by PTAC have influenced models put forth by the center. For example, in 2019, the Department of Health and Human Services (HHS) announced payment and care delivery models in primary care and kidney care. Specifically, when CMMI unveiled a set of new payment models as part of its Primary Cares Initiative in April 2019, the announcement materials acknowledged PTAC for its influence on the models’ development, also recognizing the contributions of four proposal submitters. In addition HHS held a public listening session about a potential oncology care payment model. Further, in 2020, Director Brad Smith indicated his appreciation for PTAC’s role in working with CMS, having had an opportunity to go through the PTAC process as a submitter on the CTAC proposal, and in his work at CMMI, including the implementation of the Seriously Ill Population (SIP) option within the Primary Care First payment model. At PTAC’s June 2020 virtual public meeting, Seema Verma said that “PTAC plays a vital role in our development of these models by providing practical well-vetted input and we are deeply grateful for that. And conversations with submitters who have gone through the PTAC process have informed and enriched our thinking on these issues.” PTAC recommendations can also influence CMS policy beyond affecting new CMMI models. For example, in the final Physician Fee Schedule Rule for Calendar 2020, CMS discussed a gap in codes for chronic care management services identified by stakeholders and specifically mentioned that the concern had “also been raised by the stakeholder community in proposal submissions to [PTAC].”Access OtherNo
Agency Feedback*YesAccess Comment
Agency Feedback Comment*The establishing statute requires that the Secretary review the comments and recommendations submitted by PTAC and post a detailed response to such comments and recommendations on the Centers for Medicare & Medicaid Services website. Secretarial responses are available at https://innovation.cms.gov/initiatives/pfpms/Narrative Description*The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which established PTAC, changed the way that Medicare pays physicians and other clinicians and created incentives for them to participate in alternative payment models (APMs). PTAC provides an opportunity for stakeholders to have a role in APM development. PTAC’s comments and recommendations on stakeholder-submitted proposals assist HHS as it considers new models.
Hide Section - COSTS

COSTS

Payments to Non-Federal Members*$0.00Est Payments to Non-Fed Members Next FY*$0.00
Payments to Federal Members*$0.00Est. Payments to Fed Members Next FY*$0.00
Payments to Federal Staff*$1,137,813.00Estimated Payments to Federal Staff*$1,367,212.00
Payments to Consultants*$3,317,707.00Est. Payments to Consultants Next FY*$3,188,212.00
Travel Reimb. For Non-Federal Members*$11,954.00Est Travel Reimb Non-Fed Members nextFY*$12,312.00
Travel Reimb. For Federal Members*$0.00Est Travel Reimb For Fed Members*$0.00
Travel Reimb. For Federal Staff*$0.00Est. Travel Reimb to Fed Staff Next FY*$0.00
Travel Reimb. For Consultants*$4,489.00Est Travel Reimb to Consultants Next FY*$4,623.00
Other Costs$161,449.00Est. Other Costs Next FY*$300,000.00
Total Costs$4,633,412.00Est. Total Next FY*$4,872,359.00
Federal Staff Support (FTE)*7.00Est. Fed Staff Support Next FY*8.00
Cost RemarksFederal Staff FTE Overhead related expenses are captured under "Other Costs".Est Cost Remarks
Hide Section - Interest Areas

Interest Areas

Category
Area
Health
Health Care
Hospitals
Medical Practitioners
Treatment
Aging
Medicine
Diseases
Health and Health Research
Illnesses
Hide Section - MEMBERS,MEETINGS AND ADVISORY REPORTS

MEMBERS,MEETINGS AND ADVISORY REPORTS

To View all the members, meetings and advisory reports for this committee please click here
Hide Section - CHARTERS AND RELATED DOCS

CHARTERS AND RELATED DOCS

No Documents Found
Hide Section - DATA FROM PREVIOUS YEARS

DATA FROM PREVIOUS YEARS

Committee

Data from Previous Years

 
ActionCommittee System IDCommittee NameFiscal Year
 COM-036467Physician-Focused Payment Model Technical Advisory Committee2019
 COM-034666Physician-Focused Payment Model Technical Advisory Committee2018
 COM-001946Physician-Focused Payment Model Technical Advisory Committee2017
 COM-002246Physician-Focused Payment Model Technical Advisory Committee2016