What the proposed CMS changes actually mean for you

By Physician Sense, for MDLinx
Published September 5, 2018

Key Takeaways

Some news that might have fallen through the cracks heading into the recent holiday weekend: 170 physician groups from multiple specialties sent a letter to the Centers for Medicare and Medicaid (CMS) asking them to reconsider the proposed changes to billing for evaluation and management (E&M).

The doctors behind the letter, which was distributed by the American Medical Association (AMA), struck a help-us-help-you tone, acknowledging that the administration’s proposal, called Patients Over Paperwork, though well-intentioned, “could hurt physicians and other healthcare professionals in specialties that treat the sickest patients, as well as those who provide comprehensive primary care, ultimately jeopardizing patients’ access to care.”

The changes might also hurt specialists’ wallets. In what appears to be a similar version of the AMA letter, the American College of Rheumatology put it more bluntly:

“We urge CMS to reconsider this proposal to cut and consolidate evaluation and management services, which would severely reduce Medicare patients’ access to care by cutting payments for complex office visits.”

Despite a potential pay cut, the doctors behind the AMA letter write that they like a few things, specifically:

  • Altering required documentation to focus on the patient’s duration since last visit
  • Eliminating the physician requirement to re-document information already provided by office staff or by the patient
  • Striking the need to justify a home visit in lieu of an office visit

Looking over the CMS proposal and the letters, there’s a mixed bag of winners and losers among stakeholders.

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