AMA to CMS: 'Tsunami of rules' overwhelms doctors, hurts patients

The American Medical Association is doing its utmost to light a fire under the Centers for Medicare & Medicaid Services, this time warning CMS about the impending "tsunami of rules and policies" that threaten both physicians and patients.

In a strongly worded letter from AMA Executive Vice President and CEO James Madara to CMS Administrator Marilyn Tavenner, Madara reiterates AMA's concern that the non-alignment of the Meaningful Use program, the Physician Quality Reporting System and the Value Based Modifier program forces physicians to register and report information multiple times in different formats, which is time consuming and confusing. That, coupled with the effects of the sequester, could cut Medicare reimbursement by more than 13 percent by the end of the decade.

"[T]he rules have become so complex that no one, often including the staff in charge of implementing them, can fully understand and interpret them. In many instances, physicians will be held accountable for expenses that are completely outside their control, and those treating Medicare's frailest patients are most at risk for incurring penalties. Ironically, the environment makes it difficult for physicians to invest in health information technology as well as make desired payment and delivery reforms," Madara writes in the letter.

Madara makes several recommendations, including:

  • Drop the "all-or-nothing" approach regarding meeting Meaningful Use
  • Shorten the 2015 reporting period from one year to 90 days
  • Make optional the most challenging Meaningful Use measures
  • Align the three programs so that physicians need to report one time only

Madara also warns that CMS' recent announcement that it is moving beyond Meaningful Use is "highly imprudent."  He expresses sympathy for CMS and the position it's in, but urges the agency not to go forward as currently contemplated and offers to help CMS reassess its programs.   

Many providers have expressed concern about the Meaningful Use program and other CMS initiatives. The AMA in particular has attempted to provide practical suggestions for improvement, recently publishing a framework to improve EHR usability and a blueprint to improve Meaningful Use.

To learn more:
- read the letter (.pdf)