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AMA to The Modesto Bee: Story Misrepresents AMA Committee's Role

July 29, 2013 (published)

The Modesto Bee
Letter to the Editor

To the Editor:

The Bee did a remarkable disservice to readers by printing a flawed Washington Post news story on an American Medical Association committee's role in providing expert recommendations to the Centers for Medicare and Medicaid Services ("Medical panel's estimates inflate doctors' pay," July 21, Page A-10).

In recent years, the committee has taken the initiative to identify overvalued medical services to help drive cost reduction. To date, they reviewed about 1,300 potentially misvalued services and recommended reductions to 500 previously overvalued services, redistributing $2.5 billion to primary care and other services.

The committee is currently reviewing gastrointestinal services, including colonoscopy procedures. That review will be complete next year.

But let's not forget that the Medicare physician payment system is ultimately budget-neutral. There is no financial impact if the government accepts a recommendation for increasing a medical service value because any increase is automatically offset by decreasing values assigned to all other services. It also should be noted that the annual growth in Medicare physician services has been at a historical low for each of the last three years — less than 1 percent.

The AMA ensures transparency of the process, making the data and rationale for each committee recommendation publicly available, and CMS representatives attend all RUC meetings. And while the committee submits recommendations to the Centers for Medicare and Medicaid Services for consideration each year, the agency is not obligated to accept them. The general public is also able to comment on individual procedures, and processes are in place to ensure that input from all stakeholders is considered by CMS.

Medicare provides health care coverage for millions of Americans, and it's unfortunate the article chose to play fast and loose with the facts.

Ardis D. Hoven, MD
President, American Medical Association