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

Resident debt is ruining medicine
MDedge Dermatology
VIDEO: Patient-generated health tests pose challenges, opportunities for doctors
MDedge Dermatology
Medicare at 50: Physicians brace for transition to value-based payment
MDedge Dermatology
Individualizing Patient Education for Greater Patient Satisfaction
MDedge Dermatology
UnitedHealth Group agrees to $11.5 million settlement
MDedge Dermatology
International Educational Opportunities for Dermatology Residents
MDedge Dermatology
Reflectance Confocal Microscopy: An Overview of Technology and Advances in Telepathology
MDedge Dermatology
Eight states enact telemedicine law, commission to be created
MDedge Dermatology
‘Milestone’ rules would limit profits, score quality for Medicaid plans
MDedge Dermatology
Electronic communications and liability exposure
MDedge Dermatology