The American Medical Association has sent a letter to the Centers for Medicaid and Medicare Services detailing the federal regulations that physicians consider most onerous and offering suggestions on how to improve them.
The AMA had surveyed members in response to President Barack Obama’s call for an analysis of rules with an eye to reducing regulatory burdens and received more than 2,000 responses.
“Thousands of physicians have answered the AMA’s call to identify federal rules and regulations that create significant burden for their practices and take up time that is better spent with patients,” said AMA President Cecil B. Wilson, MD, in a press release. “Physicians’ top concerns, including unfunded federal mandates, elimination of Medicare payment for physician consultations and incompatible and inconsistent quality initiatives, offer a roadmap for CMS to make strategic changes that benefit the entire Medicare system.”
According to the letter, three out of five physicians responding to the AMA’s survey said unfunded mandates, such as drug plan authorizations, the Emergency Medical Treatment and Labor Act and documentation and certification, are the most onerous regulations.
“Over the years, Medicare has demanded that physicians take on a panoply of duties aimed at achieving social justice and protecting Medicare from potential fraud by other providers,” said the letter. “While these requirements generally have laudable goals, costs frequently exceed benefits and are simply unrealistic in a program which fails to recognize the cost of practice changes implemented after 1973 and which threatens physicians with cuts of nearly 30 percent next year.”
Forty-eight percent of respondents said their second biggest concern is Medicare’s prohibition of consultation codes. The prohibition on such codes, said the letter, forces “physicians to bill for these services with lower-valued visit codes” which leads to administrative complications and revenue decreases. The AMA recommends that payment for consultations be reinstated.
More than one out of five responding physicians said the reporting requirements for the three incentive programs currently available to physicians – Physician Quality Reporting System, e-prescribing and meaningful use of electronic health records – are inconsistent. The AMA suggested eliminating the inconsistencies.
The large number of audits and inconsistent auditing policies are a burden, said 19 percent of survey respondents. “At the very least, the regulations that control these programs should be coordinated to maximize net benefits,” said the AMA.
Other concerns include complications of CMS’ enrollment program and administrative provisions implementing standards and operating rules for the exchange of information electronically, not receiving timely feedback from CMS, inadequate education and outreach to physicians from CMS about new requirements, and issues with CMS’ pain management regulations for skilled nursing facilities.