AMA cites 'burdensome' federal regs
The American Medical Association (AMA) voiced concerns over “burdensome federal regulations” in a letter sent last week to the Centers for Medicare and Medicaid Services (CMS).
“Over the years, Medicare has demanded that physicians take on a panoply of duties aimed at achieving social justice and protecting Medicare from potential fraud by other providers,” wrote Michael D. Maves, MD, MBA, author of the letter. “While these requirements generally have laudable goals, costs frequently exceed benefits and are simply unrealistic in a program which fails to recognize the cost of practice changes implemented after 1973 and which threatens physicians with cuts of nearly 30 percent next year."
On Jan. 18, President Obama issued an executive order calling on all government agencies to complete an analysis of rules that may be ineffective, insufficient or excessively burdensome. The survey was conducted earlier this year so AMA could provide CMS with physicians’ top concerns as they complete their analysis. The survey responses dealt primarily with issues under the purview of CMS, the government agency that administers Medicare and Medicaid.
The list of these burdensome regulations, along with recommendations to improve them, was obtained through an AMA survey of physicians with more than 2,000 responses from physicians and feedback from many state and medical specialty societies. Physicians who participated in the survey could select which rules and regulations drive up administrative costs, add to the burden of paperwork for their practices or interfere with patient care.
“The CMS should also allow interpreters to bill Medicare and Medicaid for translator services and if applicable treat this as a change in law and regulation for purposes of the physician payment update formula.”
A second concern expressed by nearly half (48 percent) of those who responded to the administrative burden survey involved Medicare’s decision to prohibit the use of consultation codes in Medicare and force physicians to bill for these services with lower-valued visit codes. “This puts Medicare at odds with the policies of most private payors and creates considerable confusion and administrative complications when physicians bill secondary payors for consultations,” the letter read. “The policy also flies in the face of HIPAA administrative simplification provisions that require all payors to use a common set of codes based on the AMA’s CPT.”
Payment for consultations should be reinstated, CMS should work with the AMA and other physician groups to address problems with its new patient definition and regional audit contractor and other audits of new patient visits should be suspended until this work is completed, AMA asserted.
AMA also attacked programs creating a whirlwind of information. “In our significant experience with educating physicians about federal policies,” AMA began, “[we have] found that it usually takes at least six months to adequately reach out and inform physicians about new requirements. Lawmakers' growing propensity for cramming hundreds of program changes into massive legislative vehicles with retroactive effective dates and inadequate lead time has greatly complicated things for both CMS and physicians and we sympathize with the agency’s struggle to provide adequate notice and education in the current environment.”
“We appreciate CMS’ ongoing effort to listen to our suggestions or ways to improve the implementation of new Medicare policies and ease regulatory burdens on physician practices,” the letter concluded.
Read the full letter here.
“Over the years, Medicare has demanded that physicians take on a panoply of duties aimed at achieving social justice and protecting Medicare from potential fraud by other providers,” wrote Michael D. Maves, MD, MBA, author of the letter. “While these requirements generally have laudable goals, costs frequently exceed benefits and are simply unrealistic in a program which fails to recognize the cost of practice changes implemented after 1973 and which threatens physicians with cuts of nearly 30 percent next year."
On Jan. 18, President Obama issued an executive order calling on all government agencies to complete an analysis of rules that may be ineffective, insufficient or excessively burdensome. The survey was conducted earlier this year so AMA could provide CMS with physicians’ top concerns as they complete their analysis. The survey responses dealt primarily with issues under the purview of CMS, the government agency that administers Medicare and Medicaid.
The list of these burdensome regulations, along with recommendations to improve them, was obtained through an AMA survey of physicians with more than 2,000 responses from physicians and feedback from many state and medical specialty societies. Physicians who participated in the survey could select which rules and regulations drive up administrative costs, add to the burden of paperwork for their practices or interfere with patient care.
“The CMS should also allow interpreters to bill Medicare and Medicaid for translator services and if applicable treat this as a change in law and regulation for purposes of the physician payment update formula.”
A second concern expressed by nearly half (48 percent) of those who responded to the administrative burden survey involved Medicare’s decision to prohibit the use of consultation codes in Medicare and force physicians to bill for these services with lower-valued visit codes. “This puts Medicare at odds with the policies of most private payors and creates considerable confusion and administrative complications when physicians bill secondary payors for consultations,” the letter read. “The policy also flies in the face of HIPAA administrative simplification provisions that require all payors to use a common set of codes based on the AMA’s CPT.”
Payment for consultations should be reinstated, CMS should work with the AMA and other physician groups to address problems with its new patient definition and regional audit contractor and other audits of new patient visits should be suspended until this work is completed, AMA asserted.
AMA also attacked programs creating a whirlwind of information. “In our significant experience with educating physicians about federal policies,” AMA began, “[we have] found that it usually takes at least six months to adequately reach out and inform physicians about new requirements. Lawmakers' growing propensity for cramming hundreds of program changes into massive legislative vehicles with retroactive effective dates and inadequate lead time has greatly complicated things for both CMS and physicians and we sympathize with the agency’s struggle to provide adequate notice and education in the current environment.”
“We appreciate CMS’ ongoing effort to listen to our suggestions or ways to improve the implementation of new Medicare policies and ease regulatory burdens on physician practices,” the letter concluded.
Read the full letter here.