American College of Physicians: Internal Medicine — Doctors for Adults ®


Policy briefs

From the January-February ACP Observer, copyright 2005 by the American College of Physicians.

ACP: MedPAC should champion payment changes

In two letters sent last month to the Medicare Payment Advisory Commission (MedPAC), ACP asked the advisory group to recommend significant changes to the Medicare physician reimbursement system. MedPAC advises Congress on matters related to Medicare.

The first letter, authored by College President Charles K. Francis, FACP, detailed many of the problems with the current reimbursement system and outlined strategies to correct them. The current system, the letter stated, penalizes physicians for investing in information technology, undervalues primary care services and fails to recognize—or pay for—work that falls outside a specific procedure or visit.

To remedy those problems, the College is urging MedPAC to consider several recommendations, including replacing the sustainable growth rate formula with one linking payment updates to the costs of providing services; authorizing additional Medicare payments to support the use of information technology; and exploring a severity of care adjustment factor for treating patients with chronic diseases.

In the second letter, the College joined 45 other professional medical organizations in asking MedPAC to avoid recommending budget neutral payment systems in any proposed pilot projects or pay-for-performance initiatives.

Links to the two letters are online.

College-backed sickle-cell bill becomes law

An ACP-endorsed bill to expand treatment and services for patients with sickle-cell disease, the blood disorder that primarily affects African Americans, has been signed into law.

The Sickle Cell Treatment Act (S.874/HR 1736), which was passed by Congress and signed into law earlier last fall, will increase funding for treatment and research, expand educational efforts and provide more patient services. According to the Sickle Cell Information Center, the law also earmarks $200,000 for grants to establish a demonstration project and a national coordinating center for research on prevention and treatment.

Other provisions include matching federal funds for state Medicaid departments to help cover doctor visits and lab services for sickle cell patients.

The sponsors of the original bills included Sens. Chuck Schumer (D-N.Y.) and Jim Talent (R-Mo.) and Reps. Richard Burr (R-N.C.) and Danny Davis (D-Ill.).

Information on the new law is online.


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