Chief Executive Officer, American Geriatrics Society (AGS) and AGS Health in Aging Foundation, New York, New York.
President, AGS, New York, New York, and Chair and Professor, Department of Internal Medicine, Hackensack Meridian School of Medicine at Seton Hall, Hackensack University Medical Center, Hackensack, New Jersey.
J Am Geriatr Soc. 2019 Jan;67(1):145-150. doi: 10.1111/jgs.15651. Epub 2018 Dec 4.
In July 2018, the Centers for Medicare and Medicaid Services (CMS) released its proposed Medicare Physician Fee Schedule rule for calendar year 2019 (MPFS2019). The proposal sets forth CMS-recommended updates to Medicare payment policies, payment rates, and quality provisions for services provided in the next calendar year. From year to year, the rule also can serve as a vehicle for soliciting input on new payment proposals and changes to existing policies. Among the payment and quality proposals in the MPFS2019 proposal, CMS proposed extensive changes to Current Procedural Terminology codes that are the framework for documentation and payment for office-based evaluation and management (E/M) services. The American Geriatrics Society (AGS) believes the proposed payment methodology changes for E/M services would have had a significant negative impact on care for older Americans. On September 10, 2018, the AGS submitted its comments on this proposal and other aspects of the rule, and the AGS also submitted a comment letter signed by 41 organizations from an AGS-led multispecialty coalition. The coalition also worked collaboratively on outreach to Congress, which included visits to Capitol Hill and a coalition letter stressing our collective support for reducing the burden of documentation for clinicians and our opposition to the proposed changes in payment methodology. In all letters, we noted that the AGS and members of our coalition hoped to work collaboratively with CMS and other stakeholders to develop a refined approach that would achieve the best possible outcomes for patients, particularly frail older Americans with multiple chronic conditions. In releasing their final MPFS2019, CMS postponed the E/M coding collapse for at least two years, a decision that speaks to the hard work of the AGS, its members, and the multi-specialty coalition, and which opens the door for further discussions about the future of payment for E/M services so critical to older people. J Am Geriatr Soc 67:145-150, 2019.
2018 年 7 月，医疗保险和医疗补助服务中心（CMS）发布了其 2019 年日历年度医疗保险医师费用表规则（MPFS2019）的提案。该提案规定了 CMS 对下一年度医疗保险支付政策、支付率和服务质量条款的建议更新。从一年到另一年，该规则也可以作为征求新支付提案和现有政策变更意见的手段。在 MPFS2019 提案的支付和质量提案中，CMS 提议对当前程序术语 (CPT) 代码进行广泛修改，这些代码是记录和支付基于办公室的评估和管理 (E/M) 服务的框架。美国老年医学学会 (AGS) 认为，E/M 服务拟议的支付方法变更将对美国老年人的护理产生重大负面影响。2018 年 9 月 10 日，AGS 就该提案和规则的其他方面提交了意见，AGS 还提交了一份由 41 个组织签署的评论信，这些组织来自 AGS 领导的多专业联盟。该联盟还合作向国会进行宣传，包括访问国会山以及一封联名信，强调我们对减轻临床医生文件记录负担的集体支持，以及我们对拟议支付方法变更的反对。在所有信件中，我们指出，AGS 及其联盟成员希望与 CMS 和其他利益相关者合作，制定一种经过改进的方法，为患者，特别是患有多种慢性病的脆弱老年美国人，实现尽可能好的结果。CMS 在发布其最终的 MPFS2019 时，将 E/M 编码崩溃至少推迟了两年，这一决定反映了 AGS、其成员和多专业联盟的辛勤工作，为进一步讨论至关重要的 E/M 服务支付的未来打开了大门老年人。J Am Geriatr Soc 67:145-150, 2019。
