Organized medicine collaboration scores delay in harmful Modifier 25 policy
Blue Cross Blue Shield of Michigan (BCBSM) announced (PDF) a delay in implementing its planned modifier 25 payment reduction. Originally scheduled to take effect on May 1, 2026, the BCBSM policy would reduce payment by 50% for most evaluation and management (E/M) office visits appended with modifier 25 and reported with a same-day minor procedure. This policy would financially harm physician practices and disincentivize provision of quality, efficient care. In addition, it reflects a critical misunderstanding of how the AMA/Specialty Society RVS Update Committee (RUC) valuates minor procedures commonly performed on the same day as an E/M visit.
Organized medicine quickly mobilized to fight this unwarranted payment reduction. Michigan State Medical Society (MSMS) immediately alerted physicians in the state; initiated a sign-on letter to BCBSM that urged rescission of the policy; and requested a meeting with the health plan. A team from the AMA joined the MSMS-led contingent in a March meeting with BCBSM, in which the participants skillfully outlined how this policy would undermine efficient, patient-centered care; jeopardize practice sustainability; and misalign with RUC code valuation.
This successful interim outcome reflects how the Federation of Medicine and the AMA—speaking with a unified, credible voice—can influence negative policies and protect physicians. MSMS and the AMA will continue to collaborate on this issue and urge complete rescission of BCBSM’s inappropriate modifier 25 payment policy.
AMA to Delaware lawmakers: Patients deserve physician-led care
On April 13, the AMA sent a letter (PDF) to Delaware lawmakers expressing strong opposition to Delaware House Bill 325 (HB 325), which would fundamentally alter the existing collaborative relationship between physicians and physician assistants in Delaware, including allowing physician assistants with more than 6,000 clinical practice hours to practice medicine without any physician involvement.
The AMA’s opposition to HB 325 reflects its longstanding commitment to defending the physician-led, team-based model of care that patients want and that evidence supports. As stated by AMA CEO John Whyte, MD, MPH, “fragmenting the health care team is not what patients want.” In fact, an AMA survey found that 95% of U.S. voters believe physicians should be involved in their medical diagnoses and treatment decisions. HB 325 would undermine that expectation by removing physicians from critical decision making.
The letter raises several serious concerns with HB 325 noting that it “runs counter to the national trend” evidenced by the fact that 45 states currently require physician supervision of or collaboration with physician assistants, and more than a dozen states defeated similar proposals in 2025 alone. While proponents argue that the bill would expand rural access to care and boost Delaware’s funding from the Rural Health Transformation Program, the AMA’s letter refutes both claims, stating that only 15.8% of physician assistants practice in primary care in Delaware and there is no evidence that HB 325 will increase access to care in rural areas: “Rather, evidence has shown that even when non-physicians have gained independent practice, they have failed to move into rural areas, rather they continue to practice in highly populated areas of the state.” In addition, the AMA asserts that passage of HB 325 will have minimal, if any, impact on Delaware’s overall RHTP funding based on the RHTP scoring mechanism for physician assistant scope expansion.
The letter further emphasizes that physician assistants themselves value their ability to collaborate with physicians, with AMA survey data confirming that physician assistants “depend on physicians for guidance, mentorship, and training, especially when transitioning to new specialties.” This is likely due to the fact that physician assistant two-year programs provide a generalist education with no specialty specific path. Yet a growing number of physician assistants are practicing in specialties, often without any formal training in that specialty. This underscores the “vital importance of maintaining physician-led care which is critical to support patient safety and the high-quality care that patients expect and deserve.”
In conclusion, Dr. Whyte acknowledges lawmakers’ concerns related to access to care and expresses the AMA’s commitment to partnering with Delaware on alternative solutions, including expanding access to telehealth, increasing graduate medical education positions, and providing loan repayment programs for rural physicians. As the letter concludes, “HB 325 is not the answer and instead proposes a false solution to a very serious problem.” As such, the AMA strongly urges lawmakers to vote no on HB 325.
