The American Academy of Family Physicians has announced its support for a House bill that would attempt to increase accuracy and transparency of the Medicare payment process, according to an AAFP release.
H.R. 1256, introduced by Rep. Jim McDermott (D-Wash.), would require CMS to hire independent contractors to identify and analyze misvalued codes for medical services provided to Medicare beneficiaries. The contractors would also hold an annual code review, adding to the work of the Relative Value Scale Update Committee and potentially increasing accuracy and transparency.
The American Medical Association created the RUC in 1991 to make recommendations to CMS on the relative values of CPT codes using the Resource-based Relative Value Scale. The RUC currently provides the only guidance on values for Medicare services, a fact that would change under H.R. 1256 with the addition of independent contractors.
Rep. McDermott's bill says while the RUC has been a "good faith effort" to help CMS develop the physician fee schedule, more oversight is now needed. MedPAC has previously found that while the RUC generally identifies and corrects undervalued codes, it is not similarly incented to find and correct overvalued codes. Independent contractors would assist in targeting this potential blind spot, according to the report.
Read the AAFP release on the bill to increase transparency in the Medicare payment process.
Read more on coding, billing and collections:
-CMS Starts National Coverage Analyses on Intensive Behavioral Therapy for Obesity
-Website Predicts OON Medical Costs for Consumers
-ACOG Updates Guidelines for Female OB/GYN Screenings
H.R. 1256, introduced by Rep. Jim McDermott (D-Wash.), would require CMS to hire independent contractors to identify and analyze misvalued codes for medical services provided to Medicare beneficiaries. The contractors would also hold an annual code review, adding to the work of the Relative Value Scale Update Committee and potentially increasing accuracy and transparency.
The American Medical Association created the RUC in 1991 to make recommendations to CMS on the relative values of CPT codes using the Resource-based Relative Value Scale. The RUC currently provides the only guidance on values for Medicare services, a fact that would change under H.R. 1256 with the addition of independent contractors.
Rep. McDermott's bill says while the RUC has been a "good faith effort" to help CMS develop the physician fee schedule, more oversight is now needed. MedPAC has previously found that while the RUC generally identifies and corrects undervalued codes, it is not similarly incented to find and correct overvalued codes. Independent contractors would assist in targeting this potential blind spot, according to the report.
Read the AAFP release on the bill to increase transparency in the Medicare payment process.
Read more on coding, billing and collections:
-CMS Starts National Coverage Analyses on Intensive Behavioral Therapy for Obesity
-Website Predicts OON Medical Costs for Consumers
-ACOG Updates Guidelines for Female OB/GYN Screenings