2019 Medicare Physician Fee Schedule Proposal, MOC, and Telemedicine on the Agenda for PAMED Physician Leaders

Last Updated: Aug 16, 2018

Pictured, from left to right: PAMED  President Theodore Christopher,  MD, FACEP; Rep. Mark Mustio; PAMED EVP Martin Raniowski

The 2019 Medicare Physician Fee Schedule (PFS) proposal was among the health care topics discussed by Pennsylvania Medical Society (PAMED) and state specialty society physician leaders who met in Harrisburg on Aug. 14-15, 2018. 

The Centers for Medicare and Medicaid Services’ (CMS) Medicare PFS proposed rule includes major changes to evaluation and management (E&M) services coding, payment and documentation, among other changes. The proposal, if implemented, would affect not only Medicare Part B but, ultimately, also could have an impact on Medicare Advantage and commercial plans in the future.

PAMED leadership and the Specialty Leadership Cabinet members engaged in spirited discussions regarding the 2019 Medicare PFS proposal and agreed to share their concerns about the proposal with CMS via a formal PAMED comment letter. Once the letter is finalized, PAMED will share these comments with our members prior to the public comment deadline of 5 p.m. on Sept. 10, 2018.

PAMED also encourages its member physicians to provide CMS with their comments and concerns during the comment period via this comment form. We will share – via our website, the Dose email newsletter, and social media channels – potential talking points with physicians who are interested in sending comments. Members with questions on the 2019 PFS proposal can also contact our Knowledge Center at 855-PAMED4U (855-726-3348) or KnowledgeCenter@pamedsoc.org

MOC, Telemedicine, and More

The physicians in attendance also addressed a broad range of issues, including:

  • Maintenance of Certification (MOC)PAMED physician leaders reaffirmed their commitment to keep the MOC issue at the forefront, and PAMED will remain active in its pursuit of MOC reform. 

    MOC is one of PAMED’s advocacy priorities. Get MOC updates at www.pamedsoc.org/moc, including news on the American Board of Medical Specialties’ (ABMS) Vision Commission which was created to explore ways to improve the process. PAMED Past President Charles Cutler, MD, MACP, is a member of the Vision Commission.
  • Telemedicine Legislation – Pennsylvania Representative Mark Mustio, Chair of the House Professional Licensure Committee, was honored with a certificate of appreciation for his service in the Pa. House. While Rep. Mustio will retire at the end of the 2017-2018 legislative session, he remains focused on current legislation being considered by his committee.

    During the legislature’s summer recess, Rep. Mustio has devoted time to meeting with physicians and health care organizations to discuss the need for a legal framework for telemedicine in Pennsylvania. Telemedicine legislation – Senate Bill 780, a bill strongly supported by PAMED – is currently under consideration by Rep. Mustio’s committee. Physicians can use this online form to contact their House members and express their support for telemedicine legislation.
  • Aetna-CVS merger – Physician leaders agreed to submit a letter to the Pennsylvania Office of the Attorney General and the state Department of Insurance to express the PAMED’s concern regarding the proposed merger between CVS Health and Aetna, Inc. Aetna has the second highest market share in the state, second only to Highmark. The merger could harm patient safety and quality of care in Pennsylvania and put medical treatment decisions into the hands of non-medical professionals.
  • The Social Determinants of Health (SDOH) – PAMED President Theodore Christopher, MD, FACEP, presented information on SDOH and how they determine access and quality of medical care. Dr. Christopher has been engaged in talking to county medical societies, group practices, and health systems in order to help physicians learn how to incorporate SDOH into patient care.
  • Peer Review Protections – On March 27, 2018, the Pennsylvania Supreme Court decided the medical liability case Reginelli v. Boggs. (Get PAMED’s overview of case and the decision.) The opinion signals two very significant shifts in Pennsylvania peer review analysis by narrowing the scope of the Peer Review Protection Act (PRPA). First, the Court held that a physician practice group that employed physicians and other licensed health care providers did not qualify for peer review privilege protection either for its own internal peer review activities or for peer review activities that it had been engaged to conduct on the hospital’s behalf. Second, the Court eliminated peer review protection for hospital credentialing.

    PAMED leaders agreed to collaborate with the Hospital and Healthsystem Association of Pennsylvania (HAP) to draft legislation to address the Pennsylvania Supreme Court’s decision in the case, and, once leadership approves draft language, work with HAP to find a legislative sponsor to introduce the bill.

Physicians representing the state’s medical specialties had the opportunity to meet with Matt Baker, currently the regional director for Region III of the U.S. Department of Health and Human Services (HHS). Prior to accepting his position with HHS, Baker was a longtime member of the Pa. House. He shared details on HHS’ four priority issues: the opioids crisis, health insurance reform, drug pricing, and value-based care.

Specialty leaders also heard from Curt Schroder, former Pa. House member and current Executive Director for the Pennsylvania Coalition for Civil Justice Reform (PCCJR), a statewide, nonpartisan alliance of organizations and individuals elevating awareness of civil justice issues and advocating for legal reform in the legislature. You can sign up for PCCJR updates at http://www.paforciviljusticereform.org

What's Next

PAMED’s Board of Trustees will meet next during PAMED’s annual House of Delegates (HOD) in Hershey, Oct. 26-28, 2018. You can find out more about the HOD at www.pamedsoc.org/HOD. The deadline for members to submit health care policy resolutions for consideration by physicians at the HOD is Sept. 27.

You can find meeting minutes from previous Board of Trustees meetings here. And, learn more about PAMED’s advocacy priorities at www.pamedsoc.org/advocacy

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