Physician groups call proposed fee schedule a mixed bag

Physician groups gave mixed reviews to the government’s latest attempt to change the physician payment system.

The groups, which represent doctors across the country, praised the Centers for Medicare & Medicaid Services for responding to physicians’ concerns in the physician fee schedule proposed rule released last week, but found areas they want the agency to address.

CMS issued a proposed rule to update the Medicare physician fee schedule, with changes intended to relieve the regulatory burden on doctors and other clinicians in 2018. The rule will be published in the Federal Register this week, with comments on the proposal due Sept. 11.

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The American Medical Association, the country’s largest physician group, said it found a number of positive proposed changes that would improve patient care and save taxpayer dollars.

In an announcement, the AMA praised CMS for inviting ideas for regulatory relief for physicians and said it was happy to see the agency move forward to expand the Diabetes Prevention Model, consolidate and streamline value-based payment systems to align with the Merit-Based Incentive Payment System and reduce penalties for physicians in 2018, and delay implementation of appropriate use criteria for advanced imaging services until 2019.

In a statement, the American Academy of Family Physicians (AAFP) commended CMS for trying to decrease the administrative load Medicare has placed on physicians, specifically its recognition that current evaluation and management documentation guidelines, constructed more than 20 years ago, are no longer relevant and need change.

The AAFP also agreed with CMS’ proposal to implement site-neutral provisions to new off-campus, provider-based departments and its lowering the maximum level of risk that physicians in practices with fewer than 10 physicians would face under the 2018 value modifier program from 4 percent to 1 percent.

However, the group was disappointed CMS did not take action to achieve the required minimum net expenditure reduction through identifying misvalued codes. That means physicians will not receive the full 0.5% update in 2018 called for in the Medicare Access and CHIP Reauthorization Act, said John Meigs, M.D., AAFP's president.

The American College of Rheumatology, praised some of CMS’ changes, including the revision of the value modifier. “Such improvements are necessary to ensure rheumatology practices, especially small practices and those serving rural areas, are able to continue providing high-quality care to a growing Medicare patient population,” its president Sharad Lakhanpal, M.D., said in a statement.

However, the group said it would like to see CMS make further changes, including to quality feedback reports, which it said should be simplified and streamlined.