SFMS, CMA, and AMA are aggressively involved in advocacy efforts related to the most vital issues in medicine today, including medical liability reform, Medicare physician payment reform, expanding coverage for the uninsured and increasing access to care, improving the public health, managed care reform, and others. See below for an update on issues that organized medicine has taken on:
Payment bundling initiative is announced
The Center for Medicare & Medicaid Innovation (CMMI) recently announced a “Bundled Payments for Care Improvement Initiative” and issued a request for applications. The AMA is pleased that the initiative allows for a range of models and gives applicants flexibility in how they organize their programs. There are four basic models (acute care inpatient stay bundle, episode-of-care bundle, post-acute care bundle, prospective inpatient stay bundle).
Interested applicants must submit letters of intent by September 22 for Model 1 and by November 4 for Models 2 through 4. Model 1 projects are expected to get underway in January. The Centers for Medicare & Medicaid Services (CMS) will provide data to the applicants for Models 2 through 4 and work with them to get their projects started in the spring. Click here for more information.
Physician lab requisition signature requirement retracted
The AMA and other stakeholders strongly opposed a burdensome new Medicare paperwork requirement that was scheduled to take effect in 2011. Following significant outreach to CMS concerning the impact this requirement would have, CMS issued a proposed rule that would retract the policy requiring a physician signature on laboratory test requisitions and reinstate the prior policy that does not require the physician’s signature.
Final rule on electronic prescribing penalty adds flexibility
In response to serious concerns expressed by the AMA about the e-prescribing penalty program that is scheduled to start in 2012, CMS released a final rule that adds flexibility to the exemption categories. This flexibility is intended to make it easier for physicians to avoid the penalty. In addition, CMS has extended the date to apply for an exemption to November 1, 2011. Details of the e-prescribing penalty program can be found in the September 1, 2011 SFMS blog post.
2012 Medicare payment schedule comments are submitted
CMA and AMA submitted comments to numerous proposed policies for the 2012 Medicare physician payment schedule. View CMA’s letter to CMS here. Highlights from the AMA letter include:
- With regard to the Physician Quality Reporting System, the AMA urged CMS to allow all measures in groups to be reportable as individual measures, to allow measures for registry reporting to also be reported through claims-based reporting, and expressed concern that CMS has not allowed enough time to test the interest in the Group Practice Reporting Option among groups of two to 24 physicians.
- The AMA strenuously objected to designating 2013 as the initial performance year for initial application of the value-based payment modifier in 2015.
- AMA comments urged CMS to conduct the promised comprehensive review of the Medicare Economic Index (MEI) and for the review to address the office expense categories and weights that in 2012 will be applied to the geographic practice cost index.
- The AMA opposes the proposed multiple procedure payment reduction to the professional component of 119 imaging tests, noting that no savings will be realized if these services move into hospital facility settings.
AMA comments on proposed definition of “patient-centered outcomes research”
AMA along with 26 medical specialty societies, submitted a letter to the Patient-Centered Outcomes Research Institute (PCORI) responding to its call for input on its proposed definition of “patient-centered outcomes research.” The letter conveys support for the proposed broad definition of patient-centered outcomes research, which involves a comparison of different modalities, including health delivery models, to manage a specific health problem, condition, or disease, but seeks clarification on whether a component of the proposed definition includes cost analysis.
More co-sponsors needed on private contracting legislation
The list of co-sponsors for the Medicare Patient Empowerment Act (HR 1700/S. 1042) has expanded, adding Rep. Dana Rohrabacher (R) of California and five physician members of Congress. These bills, introduced by Rep. Tom Price, MD (R-Ga.), and Sen. Lisa Murkowski (R-Ark.) are consistent with policy adopted by the AMA House of Delegates, by allowing private contracting between Medicare beneficiaries and their physicians without penalty to either party.
CMS to require Medicare enrollment revalidation by March 2013
CMS announced in August that it will require all providers and suppliers enrolled in Medicare prior to March 25, 2011, to revalidate their enrollment in Medicare. In an email to providers and in a new “MLN Matters” article, CMS states that Medicare Administrative Contractors (MACs) will send revalidation notices directly to individual providers/suppliers. A provider cannot begin the revalidation process before hearing from a MAC. Upon receiving the revalidation request from a MAC, providers will have 60 days from the date of the letter to submit complete enrollment forms. Click here for full details.
According to CMS, failure to submit the enrollment form as requested may result in deactivation of Medicare billing privileges. The AMA has significant concerns with this revalidation effort in light of the problems physicians had with past enrollment and revalidation efforts. The AMA is making this a priority and urging CMS to reconsider this action.
Medicare Part D open enrollment period starts sooner
As required by the Affordable Care Act, beginning this year the Annual Election Period for the Medicare Part D prescription drug benefit will occur from October 15 through December 7. Patients who need to change Part D plans in order to lower their drug costs or access a different formulary must enroll in their new plan by December 7.
New resource helps practices find the silver lining in cloud computing
Could your members be saving time and money by adopting ASP or cloud computing software? The AMA has developed a new educational resource, “Is an application service provider software or cloud computing service right for your practice,” to shed some light on the advantages, challenges and requirements of using online software applications. This resource discusses various operation models, as well as how physicians and practice staff may determine if one of the models fits their needs and capabilities. It also provides a handy checklist of questions to consider.
After researching and selecting a suitable delivery model, practices may consult the complementary toolkit “Selecting a practice management system,” developed by the AMA and the Medical Group Management Association (MGMA). That resource is designed to help a practice identify specific software which offers the best value for its situation. Visit http://www.ama-assn.org/go/pmc to access both resources.
Click here to view the full version of the AMA Advocacy Update.