Practice Economics

GAO questions CMS reliance on RUC to set Medicare pay rates


 

References

In an interview, Dr. Wergin said these additions helped, but that the AAFP would like to see at least one more primary care slot, as well as slots for other stakeholders. In a January 2014 letter, the AAFP called on the CMS to correct what the AAFP referred to as “a disturbing trend seen in the recommendations of RUC.” Specifically, the AAFP urged the CMS to address undervalued services, such as office-based evaluation and management (E/M) codes.

The Medicare Payment Advisory Commission (MedPAC), an independent advisory commission to Congress, has also issued several reports questioning the effectiveness of the RUC, including a 2011 white paper that expressed skepticism about the way in which data is collected by the panel. In 2013, MedPAC executive director Mark E. Miller, in testimony before the Senate Finance Committee, criticized how the RUC operated.

In the last Congress, Rep. Jim McDermott (D-Wash.), ranking member of the Ways and Means Committee’s Subcommittee on Health, introduced the Accuracy in Medicare Physician Payment Act of 2013, which would supplement the work of RUC by establishing an expert panel within Medicare to oversee the valuation of physician services and to help correct distortions in the physician fee schedule. The bill was not considered by the House.

agallegos@frontlinemedcom.com

On Twitter @legal_med

Pages

Recommended Reading

VIDEO: What you need to know about MACRA, Medicare pay
MDedge Endocrinology
Lawsuits against skilled nursing facilities
MDedge Endocrinology
Resident debt is ruining medicine
MDedge Endocrinology
VIDEO: Patient-generated health tests pose challenges, opportunities for doctors
MDedge Endocrinology
Medicare at 50: Physicians brace for transition to value-based payment
MDedge Endocrinology
UnitedHealth Group agrees to $11.5 million settlement
MDedge Endocrinology
Eight states enact telemedicine law, commission to be created
MDedge Endocrinology
ABIM’s Baron fires back after latest Newsweek salvo
MDedge Endocrinology
‘Milestone’ rules would limit profits, score quality for Medicaid plans
MDedge Endocrinology
Electronic communications and liability exposure
MDedge Endocrinology