Senators Ask CMS to Put Changes To Doc Fee Codes in Proposed Rule

June 24, 2014 Categories: All News, ACLA In The News, Featured News

Bloomberg BNA

June 23 — Twelve senators have asked the Centers for Medicare & Medicaid Services to place information on modifications of physician codes in the upcoming proposed Medicare Part B fee schedule, rather than just in the final rule.

Placing “the results of CMS’s analysis and the rationale for any payment modifications” just in the final rule “limits the ability of providers to review the rationale and various methodologies used in revising the payment codes,” the senators wrote June 13 to CMS Administrator Marilyn Tavenner.

The proposed 2015 physician rule was sent to the Office of Management and Budget on June 18 (118 HCDR, 6/19/14). The rule, which usually comes out around July 1, would set out revisions to the fee schedule and make other policy changes to be finalized in November.

Lack of Transparency

“We have concerns that the current process is not sufficiently transparent and does not allow adequate time for stakeholder engagement, feedback, and preparation before any changes are finalized,” the letter said.

The mostly Republican senators signing the letter included Johnny Isakson (R-Ga.), John McCain (R-Ariz.) and John Thune (R-S.D.), as well as Kay Hagen (D-N.C.).

The American Clinical Laboratory Association June 23 said that as “providers of millions of clinical diagnostic laboratory services for Medicare beneficiaries each year, ACLA members are concerned that the current process for identifying misvalued codes in Medicare Part B does not allow enough time for feedback or stakeholder input.”

“We respectfully request that CMS revise their procedures regarding misvalued codes and provide the time necessary for meaningful and thoughtful comment, which the current timeline does not allow,” Alan Mertz, ACLA president, said in a statement.

House Members’ Letters

The letter follows correspondence from House members in April asking that feedback from providers be considered before finalizing new payment codes (84 HCDR, 5/1/14).

In their letter to Tavenner, the 12 senators asked that the agency “strongly consider revising the current process.”

The current system “makes it difficult for providers to prepare for any changes to payment, including how any revisions might impact their practices and patients.”

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