Wednesday, Sept. 5, 2012
This Week's News
Physician committee brings wealth of experience to delivery and payment innovation
AMA calls for revisions to Medicare's proposed fee schedule for 2013
New primary care initiative to advance transformation of care delivery
Fact sheets examine key trends from medical education to physician pay
This Week's News
AMA calls for revisions to Medicare's proposed fee schedule for 2013
Key provisions of the proposed 2013 Medicare physician fee schedule must be modified to ease physicians' growing burden, the AMA urged the Centers for Medicare & Medicaid Services (CMS) in a comment letter submitted Tuesday.
The AMA commends CMS for proposing to pay for a variety of care coordination services but also presses the agency to make a number of key changes to the proposed rule, including:
- Removing a proposal to reduce payment for certain procedures performed on the same day. The procedures in question are not commonly billed together.
- Striking a proposal to pay certified registered nurse anesthetists for chronic pain management services. The AMA maintains that only physicians have the training and experience to manage the associated medical risks.
- Allowing physicians in the Group Practice Reporting Option of the Physician Quality Reporting System (PQRS) also to report on measures to meet the program requirements as individuals.
Meantime, the proposed rule does act on earlier AMA recommendations, spelled out in a letter to CMS, to streamline converging penalty programs by making some allowances for physicians to avoid penalties if they meet requirements for other overlapping programs. Among these improvements are the following provisions:
- Physicians who meet the PQRS requirements will be exempt from application of the so-called "value-based modifier" unless they volunteer to be in a pool for possible payment increases or deductions.
- Physicians who seek administrative claims review can avoid penalties tied to the value-based modifier and the PQRS.
- Individual physicians who successfully report on one PQRS measure or measures group will be able to avoid the PQRS penalty through new reporting options.
- Physicians who attest to the electronic health record meaningful use program will be exempt from ePrescribing penalties.
- An appeals process will be established for the ePrescribing program.
While the AMA has expressed its appreciation that CMS does not plan to apply the value-based modifier to individual physicians in the initial stage, the comment letter presses the agency to make a number of changes to increase the ability of physicians to succeed in the program.
The final rule is expected to be issued by Nov. 1.
