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June 16, 2015
Medicare IPAB Repeal Bill Advances in House
House lawmakers are poised to pass bipartisan legislation to eliminate the Medicare Independent Payment Advisory Board (IPAB), an independent body that would recommend Medicare cuts to Congress when program costs exceed spending growth targets.
The House Ways & Means Committee approved the "Protecting Seniors' Access to Medicare Act of 2015" (HR 1190) during a markup session on June 2. The bill, which has 235 cosponsors, is expected to go to the House floor for a vote soon. Physician associations, such as the CAP and the American Medical Association (AMA), have supported repeal of the IPAB since its inclusion in the 2010 Affordable Care Act.
IPAB-repeal legislation had passed the House in previous years, but the Senate, controlled by Democrats at the time, had failed to take up the bill and the White House threatened to veto it. If HR 1190 passes the House, the bill would need to pass the Senate and face another potential veto threat as the Obama Administration has opposed attempts to erode provisions in the Affordable Care Act.
The Affordable Care Act calls for the creation of the 15-member board IPAB appointed by the president and confirmed by the Senate to study the Medicare program and ensure costs are contained. The IPAB would be similar to the current Medicare Payment Advisory Commission (MedPAC) which advises Congress on Medicare policy. Unlike MedPAC, Congress would be bound to IPAB's recommendations to curb spending or find alternative ways to make cuts.
To date, President Obama has yet to appoint members to the IPAB as per capita Medicare spending growth has yet to exceed actuarial targets.
Register for the CAP's Proposed Medicare Physician Fee Schedule Webinar
Sign up for the College's July 8 webinar "Understanding the 2016 Medicare Physician Fee Schedule Proposed Rule." Throughout this hour-long panel discussion, CAP experts will explain the changes proposed by the CMS regarding the 2016 fee schedule.
The proposed fee schedule will contain reimbursement changes affecting pathologists. During this session, attendees will learn about the proposed rule's pathology-related policies, the potential impact on pathologists, and the CAP's advocacy efforts to impact the CMS' proposal prior to its finalization.
AMA Calls for 2-Year Grace Period on ICD-10 Implementation
Physicians in the AMA House of Delegates closed its 2015 Annual Meeting with new policies advocating for a two-year grace period during the upcoming transition to the ICD-10 diagnosis coding set.
The CAP encourages members to strengthen pathology's voice at the AMA by becoming a member of the association. The size of the CAP's delegation at the AMA is representative of the number of CAP members who are also AMA members. View the AMA's website for more information about becoming a member.
The CAP and Pathology Section Council represented pathologists and their patients at the meeting. The CAP had advocated strengthening the draft AMA Medical Code of Ethics that is being modernized and opposed a resolution to further protect the self-referral of physician services.
In other Annual Meeting action, the House of Delegates called for a two-year grace period during which physicians will not be penalized for errors, mistakes, or problems outside their control after they adopt ICD-10 on October 1. The AMA will advocate for the Congress and the Obama Administration to prevent widespread disruption to physician practices created by the ICD-10 transition and ensure patients continue to receive necessary services.
Only Medical Reasons for Immunization Exemptions
Other policies adopted at the meeting included encouraging states to eliminate philosophical and religious exemptions from state immunization requirements. The AMA supports immunization of the patient population except in cases where there is a medical reason for not being vaccinated.
The AMA will work to disseminate education materials about the effectiveness of vaccines to states and recommend that states have a process involving qualified public health physicians to determine which vaccines are mandatory for admission to school and other identified public venues.
Transparent, Physician Friendly MOC
Delegates also adopted a policy that asks the American Board of Medical Specialties (ABMS) to urge full transparency related to the costs of preparing, administering, scoring, and reporting maintenance of certification (MOC) exams. Other related MOC policies adopted during the meeting state:
- Any assessment should be used to guide physicians' self-directed continuing medical education study.
- Specific content-based feedback after any assessment should be provided to physicians in a timely manner.
- Multiple options should be available for how an assessment could be structured to accommodate different learning styles.
- Physicians need to know what their specific MOC requirements are and the timing around when they must complete those requirements. The policy directs the AMA to ask the ABMS and its member boards to develop a system to alert physicians to the due dates of the multi-stage requirements of MOC.
- Part III of the MOC exam, typically known as the high-stakes exam, should be streamlined and improved. The policy also calls for exploring alternative formats.
Reducing the Risk of Concussions in Youth Sports
With a growing concern over sports-related head injuries, new AMA policy supports requiring youth athletes who are suspected of having sustained a concussion to be removed immediately from the activity and allowed only to return with a physician's written consent.
The policy also encourages the adoption of evidence-based, age-specific guidelines for physicians, other health care professionals and athletic organizations to use in evaluating and managing concussion in all athletes as well as the development and evaluation of effective risk reduction measures to prevent or reduce sports-related injuries and concussions. According to the Centers for Disease Control and Prevention, between 1.6 million and 3.8 million sports- and recreation-related traumatic brain injuries, including concussions and other head injuries, occur in the US every year.
At the upcoming CAP '15, CAP members will hear from forensic neuropathologist Bennet I. Omalu, MD, MBA, MPH, FCAP, who will discuss his work on chronic traumatic encephalopathy (CTE). Learn more about THE Pathologists’ Meeting October 4-7 in Nashville.
Unmatched Medical Students
The AMA resolved to continue studying and monitoring this issue of unmatched medical students. In recent years, there has been continued growth in enrollments in medical schools as well as the imminent unification of the accreditation systems for allopathic and osteopathic residency programs.
The House of Delegates adopted a resolution that the AMA work with other key stakeholders and interested bodies on developing potential pathways for reengagement in medicine following an unsuccessful match. The AMA would report back to the House of Delegates on the results of those discussions.
STATLINE Wins APEX Award of Excellence
In the 27th annual APEX Awards for Publication Excellence, the CAP's STATLINE earned a 2015 Award of Excellence in the Electronic & Email Newsletter category. APEX awards are based on quality in graphic design, editorial content, and/or the ability to achieve overall communications excellence. APEX's Award of Excellence recognizes exceptional entries submitted in dozens of individual categories covering print and digital media.
Since 1979, members of the College have read STATLINE as their official source for advocacy and policy news from Washington, DC. STATLINE provides its target audience of pathologists with news articles on topics ranging from federal regulation to legislation and local grassroots action. In 2015, CAP members began receiving their STATLINE electronic newsletter issues on a weekly basis instead of every other week.
For the 2015 APEX contest, STATLINE's coverage of the 2015 Medicare Physician Fee Schedule had been entered.