August 2013
The essential resource for your practice
Volume XXI, Number 8

Voice Your Opinion on Proposed Fee Schedule Changes for 2014

On July 8, 2013, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule (CMS-2013-0155-0010) that would update policies and payment rates for services furnished under the Medicare Physician Fee Schedule (PFS) for calendar year 2014. The proposed rule estimates a 24.4 percent drop in payment rates and calls for several changes to the Physician Quality Reporting System (PQRS), the Medicare Electronic Health Record (EHR) Incentive program, and the Physician Compare tool on the Medicare.gov website. see more>>

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Coding Corner:

New CCI Edit

House Committee Passes SGR Repeal Legislation

On July 31, the House Energy & Commerce Committee voted 51 to 0 in favor of H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013. The bill, authored by Rep. Michael Burgess (R-TX-26), MD, replaces the sustainable growth rate (SGR) formula with a 0.5 percent payment increase for physicians from 2014 through 2018. Additionally, the legislation supports fee-for-service (FFS) but calls for the formation of new payment models and quality reporting. The bill will now move to the floor for a full vote by the House of Representatives. H.R. 2810 is just one of multiple bipartisan proposals for SGR reform currently being vetted by key Congressional committees. The House Ways and Means and Senate Finance committees have also been working to develop similar bills.

Before passage, the bill received an amendment from bill sponsor Burgess and Rep. Frank Pallone (D-NJ-6).  The “Manager’s amendment,” as it is called, expands the availability of Medicare data, encourages the use of care coordination and medical homes, clarifies the language related to the quality update incentive program, and clarifies the intent and function of the alternative payment model section.

The AUA, along with other physician groups and the Alliance of Specialty Medicine, has been actively engaged with lawmakers in the development of these pieces of legislation, providing feedback and comments to key leaders. The AUA is largely in support of H.R. 2810 as passed on July 31, although there are elements of it that we do not like and are working to have removed. Specifically, the bill contains a penalty for those who either do not meet certain quality measures within FFS Medicare or chose not to participate in the FFS quality reporting program. The Association will continue to work with lawmakers as the bill moves forward.

For The Record

A recent survey report from Black Book Rankings indicates that health care providers are making changes in their medical record keeping software. The survey was a follow-up to the respondents from a prior Black Book poll of 17,000 EHR users to measure ongoing satisfaction and to determine what vendors are the beneficiaries of replacement strategies. The report indicates that urology is among the specialties expressing the highest dissatisfaction. Others included nephrology, gastroenterology and ophthalmology.  

Advocacy Lessons Learned from Alliance of Specialty Medicine Fly-In

By Eugene Rhee, MD, AUA Gallagher Scholar

On July 18-20, a band of eight urologists convened on Capitol Hill representing urology’s interest from all fronts: large practice, academia, small practice, and employee based. The Alliance of Specialty Medicine was formed a decade ago as a coalition of specialty U.S. physicians who, by effectively banding together, would create a dynamic and effective lobbying force. This annual meeting is called the “The Alliance of Specialty Medicine Fly-In.”

This band of urologists flew in, all well-seasoned in the AUA/ AACU’s efforts with the annual Urology Joint Advocacy Conference (JAC) in Washington, DC in past years. What was different was an active engagement with other specialty physicians who have been involved in their own society’s advocacy and grassroots activities, of which many mirror what we as urologists have been doing for years at the JAC: advancing the legislative agenda.