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ACR responds to 2018 Medicare proposed rule
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The American College of Rheumatology has responded to the CMS release of the 2018 Physician Fee Schedule Proposed Rule, according to a press release.
“We are particularly pleased to see that CMS recognizes the need to revise the value modifier (VM), as this program imposes a significant regulatory burden” Sharad Lakhanpal, MBBS, MD, president of the American College of Rheumatology (ACR), said. “The proposed changes would ease the automatic payment adjustment from -4% to -2% for groups of 10 or more clinicians who do not meet minimum quality reporting requirements; and from -2% to -1% for solo practitioners and groups of two to nine clinicians. While the reductions in penalties represent a move in the right direction, the ACR believes CMS should establish a VM adjustment of 0 for 2018.”
In addition, the ACR supported the delay in implementation for diagnostic imaging studies, as well as showed support for larger exemptions to the program.
“These changes would maximize patients’ access to critical diagnostic testing,” Lakhanpal said. “However, there are several areas we would like to see CMS address, such as the quality feedback reports. The ACR believes that the process for receiving real-time feedback on performance should be simplified and streamlined, as many physicians have expressed concern that the current process is slow and unnecessarily complicated. Specifically, the rheumatology community proposes that quality and resource use reports (QRURs) be issued on a quarterly basis in a user-friendly format. We also recommend lengthening the appeal period to 90 days.”
In addition, the ACR expressed concern for practice expense reimbursement cuts for injection codes.
“The existing codes no longer reflect the breadth of services required by many Medicare beneficiaries, especially those with multiple chronic conditions who require extensive evaluations and treatment regimens,” Lakhanpal said. “Furthermore, the ACR would like to see changes to the per-beneficiary payment model so that payment is based on services provided rather than specialty designation.”
Lakhanpal added, “The ACR also reiterates its support for assigning a unique J-code to each biosimilar of a particular reference product, so that physicians can better track and monitor their effectiveness and ensure adequate pharmacovigilance in the area of biosimilars.”
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