The Centers for Medicare & Medicaid Services (CMS) has released its Physician Fee Schedule Proposed Rule for 2018, with the goal of updating its payment and policies to alleviate the regulatory burdens on providers, strengthen the patient-clinician relationship, and increase flexibility in care delivery.
"Doctors want to spend less time on burdensome regulations from Washington, D.C., and more time with their patients," said CMS administrator Seema Verma in a press release.
The American College of Rheumatology (ACR) responded to the proposed rule in a statement from its president Sharad Lakhanpal, MD, expressing encouragement that CMS has asked for significant stakeholder input on topics such as reporting requirements, evaluation and management codes, relative value units, appropriate use criteria, and reimbursement for biosimilar products. Improvements in these areas will help ensure that high-quality rheumatology care is maintained, particularly for small practices and in underserved areas, explained Lakhanpal of the University of Texas Southwestern Medical Center in Dallas.
"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," he noted.
The suggested changes involve a shift in the automatic payment adjustment from -4% to -2% for groups of 10 or more providers not meeting minimum quality reporting requirements and from -2% to -1% for groups of fewer than 10. "While the reductions in penalties represent a move in the right direction, the ACR believes CMS should establish a VM adjustment of zero for 2018," he stated.
ACR also was pleased with the proposed delay in implementation of appropriate use criteria for diagnostic imaging procedures, again calling for greater leeway for small groups and in rural areas, in order to ensure patient access to vital diagnostic tests.
One area needing further attention, according to the ACR, is in quality feedback reports, which should be simplified, with quality and resource use reports being issued quarterly and with an appeal period of 3 months. In addition, the ACR objects to the proposed decreases in reimbursement for injections.
"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 concluded.
The college plans to review the proposed rule in detail during the coming weeks and will offer detailed suggestions and comments "to ensure better care and lower costs for the millions of Medicare beneficiaries living with rheumatic diseases."