Thanks to the many AGS members who have contacted Congressional representatives to convey concerns about the proposed change to the evaluation and management (E/M) payment codes in the Medicare Physician Fee Schedule Proposed Rule for 2019 (#MPFS2019).
Several AGS leaders who made these calls noted that Congressional staff are interested in gaining a better understanding of the proposal and the concerns we have. You may find it helpful to include these links in follow-up thank you notes (also a great best-practice recommendation) to Hill staff, who may end up using these resources to further educate your representatives:
- The American Medical Association (AMA) and about 170 other medical groups—including the AGS—sent this brief letter to CMS Administrator Seema Verma applauding efforts to reduce excessive documentation but noting several important “unanswered questions and potential unintended consequences” in the proposal to collapse E/M payment rates.
- In this recent Perspective piece for the New England Journal of Medicine, Drs. Zirui Song and John Goodson of Harvard Medical School and Massachusetts General Hospital note how, “[d]espite the admirable intention of reducing burden, the [current CMS proposal] poses risks for Medicare beneficiaries with the most complex needs and may exacerbate workforce deficiencies."
- Writing for the Health Affairs blog, Drs. Robert Berenson and Alan Lazaroff—a health policy expert and a seasoned geriatrician with policy expertise, respectively—reinforce how CMS’s recommended approach to burdensome documentation guidelines “would have serious negative consequences. If adopted, the proposal would move the fee schedule in the opposite direction from our broad objective of moving payment from ‘volume to value.’”
The AGS is continuing to lead a 40+ member coalition developing a joint letter to key Committees (the Senate Finance Committee and the House Energy & Commerce and Ways and Means Committees) with jurisdiction over Medicare, as well as a separate letter to CMS directly expressing our concerns and recommendations for moving forward. Additionally, we are working on our own AGS response letter to the proposed rule, which will address the E/M payment change and a number of other proposals in the #MPFS2019 based on our unique perspective representing the geriatrics healthcare workforce.