MGMA, AAFP implore CMS to reconsider fee schedule changes, PQRS
The Medical Group Management Association (MGMA) and the American Academy of Family Physicians (AAFP) have sent separate letters asking the Centers for Medicare & Medicaid Services (CMS) to revise its proposed Medicare Part B Physician Fee Schedule for 2012 to lessen administrative burdens related to IT and adjust the value of primary care services.
The AAFP sent recommendations related to the proposed rule. For example, author Lori J. Helm, MD, board chair for the organization, urged CMS that it should:
“Like CMS, we are interested in further improving physician care coordination within the statutory structure for physician payment and quality reporting, particularly for a beneficiary’s transition from the hospital to the community,” Helm concluded. “We welcome the opportunity to collaborate with CMS on this effort and stand ready to assist, as needed.”
William F. Jessee, MD, president and CEO of MGMA, said that CMS should use its regulatory authority to deem all physicians that meet meaningful use requirements as also successfully meeting all e-prescribing and Physician Quality Reporting System (PQRS) requirements in each corresponding performance year.
“Eligible professionals that successfully meet the meaningful use requirements should automatically earn the bonus for PQRS and avoid penalties for both electronic prescribing and PQRS,” Jessee wrote.
MGMA also stated it is “extremely concerned” with CMS’ use of quality-related payment reductions to adjust Medicare allowables. “This will lead to significant administrative problems for group practices, as well as CMS and its contractors as they attempt to administer what would amount to thousands of individual physician level Medicare fee schedules,” the letter continued.
"MGMA appreciates your consideration of these comments and looks forward to collaborating with CMS to educate medical group practices on the numerous Medicare program changes," Jessee concluded.
Read the AAFP letter here.
Read the MGMA letter here.
The AAFP sent recommendations related to the proposed rule. For example, author Lori J. Helm, MD, board chair for the organization, urged CMS that it should:
- Finalize the decision to add smoking cessation services to the list of approved telehealth services.
- Validate currently assigned physician work and time values based on a valid documentation sample.
- Establish a more timely review of misvalued services. “The AAFP is encouraged that the agency has included evaluation and management services in its ongoing efforts to identify, review and validate potentially misvalued codes,” Helm wrote.
- Consolidate the formal five-year review of work and practice expense with the annual review of potentially misvalued codes.
“Like CMS, we are interested in further improving physician care coordination within the statutory structure for physician payment and quality reporting, particularly for a beneficiary’s transition from the hospital to the community,” Helm concluded. “We welcome the opportunity to collaborate with CMS on this effort and stand ready to assist, as needed.”
William F. Jessee, MD, president and CEO of MGMA, said that CMS should use its regulatory authority to deem all physicians that meet meaningful use requirements as also successfully meeting all e-prescribing and Physician Quality Reporting System (PQRS) requirements in each corresponding performance year.
“Eligible professionals that successfully meet the meaningful use requirements should automatically earn the bonus for PQRS and avoid penalties for both electronic prescribing and PQRS,” Jessee wrote.
MGMA also stated it is “extremely concerned” with CMS’ use of quality-related payment reductions to adjust Medicare allowables. “This will lead to significant administrative problems for group practices, as well as CMS and its contractors as they attempt to administer what would amount to thousands of individual physician level Medicare fee schedules,” the letter continued.
"MGMA appreciates your consideration of these comments and looks forward to collaborating with CMS to educate medical group practices on the numerous Medicare program changes," Jessee concluded.
Read the AAFP letter here.
Read the MGMA letter here.