AMA Adopts Endocrine Society Resolution Opposing Medicare's Proposal To Eliminate Payments For Specialists

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Endocrinology
Article Date: 11 Nov 2009 - 18:00 PST

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The American Medical Association's (AMA) House of Delegates adopted a resolution opposing all public and private payer efforts to eliminate physician consultation services. Physicians providing inpatient and outpatient consultation services play a crucial role in diagnosing and caring for patients with complex medical conditions.

The resolution, introduced by The Infectious Disease Society of America and co-sponsored by The Endocrine Society, suggests that the AMA work with the Centers for Medicare and Medicaid Services (CMS) and other interested physician groups to address concerns associated with consultation codes. Late last month, CMS formally eliminated the use of these codes for the care of Medicare patients.

"CMS' decision to eliminate consultation services imposes additional hurdles for patients," said Robert Vigersky, MD, president of The Endocrine Society. "Removing these codes may limit a patient's ability to access the specialized care that may be needed to manage serious and chronic medical conditions and also result in decreased availability of endocrinology services in hospitalized patients. This decision clearly fails to recognize the value of specialized care."

Endocrinologists and numerous physician groups have been collaborating through the AMA's Current Procedural Terminology (CPT) Editorial Panel to address CMS' concerns with the existing set of consultation codes.

Specifically, the resolution states that the:

- AMA oppose all public and private payer efforts to eliminate payments for inpatient and outpatient consultation service codes and support legislation to overturn recent CMS' action to eliminate consultation codes;

- AMA work with CMS and interested physician groups through the CPT Editorial Panel to address all concerns with billing consultation services either through revision or replacement of the current code sets or by some other means; and

- AMA, at the conclusion of the CPT work, collaborate with CMS and interested physician groups to engage in an extensive education campaign regarding appropriate billing for consultation services.

"This resolution is a strong statement by the medical community regarding the essential and unique care that specialists provide toward the diagnosis and treatment of patients," said Vigersky. "The Endocrine Society looks forward to working with the AMA, CMS and others in the medical community to address this serious issue."

Source
The Endocrine Society