AMA calls on CMS, policymakers to streamline federal programs

The American Medical Association announced it has issued a letter to CMS expressing concern over the effect of Medicare incentive programs on physicians and their practices.

In the letter, the AMA asks for simplification of CMS’ policies regarding several of its programs, including Meaningful Use (MU), the Physician Quality Reporting System (PQRS) and the Value-based payment Modifier (VBM), and offers recommendations to improve each.

James L. Madara

“These programs, with often incomprehensible, conflicting requirements and flawed implementation processes, are all entering their penalty phases and pose a risk to the stability of the Medicare program that many policymakers do not seem to appreciate,” AMA executive vice president James L. Madara, MD, wrote in the letter. “The AMA calls on CMS to synchronize and simplify the requirements for avoiding these penalties, and to reverse its proposals to raise total penalties from these programs to 10% or more in the foreseeable future.”

In the letter, the AMA recommends the MU’s “all-or-nothing” provision be removed or, at the very least, make optional those reporting measures that may be outside the physician’s control. They also recommend physicians be required to meet only one standard, rather than MU, PQRS and VBM. AMA further recommends the MU 2015 reporting period be shortened to 90 days.

Additionally, the AMA recommends the PQRS 2013 aggregate data be released, an appeals process be created and a set of claims-based measures and reporting options be developed.

The VBM should be changed by not increasing penalties, making the budget-neutral tier process optional, and CMS should ask Congress to provide a longer phase-in period and more flexibility in implementation of the VBM, according to the AMA.

While the letter states there are “significant challenges” facing physicians with the regulation, it noted that CMS faces challenges of its own.

“To be clear, the AMA has a great deal of sympathy for CMS and the position it finds itself in. It is hard to take the long view in an agency struggling to meet unrealistic deadlines with inadequate resources and a flawed IT platform,” Madara wrote. “However, the current strategy of aggressively moving forward with policies that place an ever increasing burden on both CMS and physicians, combined with the flawed roll-out of the Medicare claims data release and Open Payments program and the problems with these programs, threatens to do serious damage to the agency’s image and to physician confidence in the government’s stated goal of achieving a health care system that delivers more value for the dollar.”