AAMC Testifies before PPAC
on Physician Payment Update and SGR Methodology
March 29, 2002 - At the March 25-26 meeting of the
Practicing Physician's Advisory Council (PPAC), Albert Bothe,
Jr., M.D., executive director, University of Chicago Faculty
Practice Plan, compliance officer and professor of Clinical
Surgery, University of Chicago Medical School, and medical
director, University of Chicago Health Plan and a member of
AAMC's Group on Faculty Practice Steering Committee and chair
of its Subcommittee on Legislative and Regulatory Issues,
testified
on behalf of the AAMC on the physician payment update and
the Sustainable Growth Rate (SGR).
PPAC is a mandated advisory body to the Department of Health
and Human Services (HHS) that provides input on regulatory
and carrier manual issues relevant to physicians. The meeting
covered a variety of topics, including Medicare beneficiary
access to physicians, the role of carriers and carrier medical
directors, the status of revising Evaluation and Management
CPT code Documentation Guidelines and HIPAA. Since the announcement
of the -5.4 percent update to the 2002 Conversion Factor,
the physician community has been making a concerted effort
to identify flaws in the SGR methodology and to identify the
impact of the negative update on physicians' practices and
on beneficiary access to care. The AAMC has been participating
with an AMA-led workgroup on these issues.
PPAC members approved recommending that the Centers for Medicare
and Medicaid Services (CMS) support legislation that would
repeal the 5.4 percent decrease and use revised methodology
to refigure payment schedules for 2003 and beyond.
The panel also recommended the agency implement suggestions
regarding administrative changes that could be made CMS in
its calculations of the update. House Ways and Means Committee
Chairman Bill Thomas (R-Calif.) and Ways and Means Subcommittee
on Health Chairwoman Nancy Johnson (R-Conn.) offered such
suggestions in their March 21 letter to CMS Administrator
Thomas A. Scully. Specifically, suggestions were made regarding
the way that the agency measures physician productivity and
its assumptions about how physicians will respond to decreased
payments and how factors affecting the cost of practice are
taken into account.
Information:
Denise Dodero, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
ddodero@aamc.org
(202) 828-0493
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