CMS keeps physician Medicare input link intact; AMA urges local presence

Carrier advisory panels and medical directors are seen as ways doctors can influence coverage decisions.

By Markian Hawryluk, AMNews staff. Dec. 24/31, 2001.

San Francisco -- Rumors of the demise of Medicare carrier advisory committees and medical directors in each state may have been greatly exaggerated.

At the recent AMA Interim Meeting, an official from the Centers for Medicare & Medicaid Services voiced strong support for the continued need for the committees and medical directors.

"The agency fully supports carrier medical directors and carrier advisory committees," said Barbara Paul, MD, director of the Physicians' Regulatory Issues Team at the CMS Center for Medicare Management. "We really believe in their value to the program, and there has been no pulling back from both CMDs and carrier advisory committees. So I want you to hear that loud and clear."

Dr. Paul spoke to delegates as they debated and later passed a resolution calling for the AMA to push CMS to retain the physician input that the committees and medical directors provide. In August, CMS had issued a draft policy that would give Medicare contractors the flexibility to change the advisory panel and medical director system structure and process, including eliminating individual state entities and moving to regional ones.

Joseph Bailey, MD, a rheumatologist from Augusta, Ga., said having physicians who can advise the carrier and communicate with other doctors in the state is vital to maintaining a positive relationship between physicians and Medicare.

"After 10 years of repetitive difficulty, we had found in the forum provided by the carrier advisory committee, and through the medical director for the carrier, the opportunity to do something constructive to influence the program in Georgia," Dr. Bailey said. "We felt that if this is extended to a regional level of activity, that it will decrease the various states' individual input into the issues about Medicare." [...]