ISMA plans to join the AMA, its federation members and other health professionals in asking Medicare officials not to implement two parts of the Centers for Medicare & Medicaid Services’ (CMS) proposed physician fee schedule for 2019.
The first provision would reduce the number of physician office-visit payment rates from eight to two. The AMA found that collapsing the number of payment codes would slash compensation for
numerous specialties, including hospice, oncology, obstetrics/gynecology and surgery, causing unintended consequences.
“We oppose the implementation of this proposal because it could hurt physicians and other professionals in specialties that treat the sickest patients, as well as those who provide comprehensive primary care, ultimately jeopardizing patients’ access to care,” the Aug. 20 draft letter to CMS Administrator Seema Verma says.
The letter will also urge CMS not to reduce payments for multiple office services provided on a single day, saying the possibility was already factored into previous valuations for the affected codes. The change could also negatively affect services such as chemotherapy administered in doctors’ offices, the letter says.
Instead of implementing the policies in 2019, the letter urges CMS to join an AMA workgroup of physicians and other health professionals in finding alternative solutions in time for 2020. The letter also expresses appreciation to CMS for working with stakeholders on other proposed changes, which simplify and reduce documentation requirements for Evaluation and Management (E/M) services
“Physicians and other health professionals are extremely frustrated by ‘note bloat,’ with pages and pages of redundant information that makes it difficult to quickly find important information about the patient’s present illness or most recent test results,” the letter says. “Several of the documentation policy changes included in the proposed rule will go a long way to alleviating this problem, and the undersigned organizations urge immediate adoption:
- Changing the required documentation of the patient’s history to focus only on the interval history since the previous visit;
- Eliminating the requirement for physicians to re-document information that has already been documented in the patient’s record by practice staff or by the patient; and
- Removing the need to justify providing a home visit instead of an office visit.
AMA’s analysis of the 2019 proposed rule, as well as links to the complete text, fact sheets and fee tables provided by CMS, are online in the
July 18 issue of e-Reports.
Sept. 10 is the deadline to submit comments about the proposed rule directly to CMS.
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