Medical Association Issues Statement On Physician Payments For Educational Activities - American Association Of Clinical Endocrinologists

Main Category: Endocrinology
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At its Board of Directors meeting Saturday, the American Association of Clinical Endocrinologists (AACE) endorsed a statement that endocrinologists have a greater responsibility than ever to educate physician colleagues, allied health professionals, and patients on the most up-to-date treatments and guidelines in endocrinology. This is in response to the worsening national epidemic of poorly controlled diabetes and metabolic diseases, the shortage of endocrinologists to treat these conditions, and the rapid expansion of therapeutic innovations that can improve patient outcomes.

Ongoing education in new medications and devices is necessary for their safe and effective use, especially in complex diseases like diabetes. Educational presentations provide the scientific background, the data, and the reasoning to understand new treatment options and make better use of old ones. To make this education accessible it must take place in as many settings as possible, and when sponsored by industry it operates under very strict rules of conduct.

Educators spend many hours preparing their presentations, taking time away from their practices, and traveling in order to participate in educational programs. The legitimate concerns surrounding the abuses of a limited number of physicians should not undermine a fundamental tenet in the practice of medicine - the commitment to the lifelong study and furthering of medical knowledge required to continuously improve patient care.

In May 2009, AACE issued a position statement supporting the ethical collaboration between physicians and industry, noting that "there is no inherent conflict of interest in the working relationship of physicians with industry and such work has resulted in many medical advancements and improved health outcomes."

In summary:

- There are too few endocrinologists to treat the worsening epidemic of diabetes and metabolic disease

- New therapeutic options and guidelines to treat disease require education for safe and effective use

- Educational programs, including those sponsored by industry, expand the number and types of health professionals who can effectively treat patients with diabetes and metabolic diseases

Source:
American Association of Clinical Endocrinologists (AACE)

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CMS Releases 2011 Medicare Physician Fee Schedule Final Rule

Statement by APTA President R. Scott Ward, PT, PhD

Today the Centers for Medicare and Medicaid Services (CMS) released the 2011 Medicare Physician Fee Schedule Final Rule, which, I am disappointed to report, contains significant cuts to outpatient therapy services that will negatively impact physical therapists and millions of patients. Under a new multiple procedure payment reduction (MPPR) policy, physical therapists will see a 7%-9% reduction in payment for these services starting January 1, 2011.

The association is deeply concerned about this policy. APTA has worked diligently these past few months educating CMS, White House officials, the Medicare Payment Advisory Commission (MedPAC) and other policymakers about the detrimental effect the MPPR policy will have on physical therapists and the patients we serve. The initial MPPR proposal called for an 11%-13% cut in payments and, while our actions did have an impact, we are nonetheless seriously troubled by this final rule. This lesser reduction of 7%-9% will still mean disturbing repercussions for outpatient therapy providers and their patients. As such, APTA is now aggressively exploring all legal, regulatory, and legislative options to negate the MPPR policy.

APTA believes this policy is unjustified, as it is based on flawed analysis conducted by CMS in the agency's effort to avoid duplication of payment when multiple services are furnished during a session or day. As we know, the practice expense values for the codes reported by physical therapists had already been reduced to avoid duplication during the Relative Value Update Committee (RUC) review process, thus making the MPPR an unfair and unnecessary policy. In addition, CMS only examined the median number of units in private practice therapists' offices and physician offices, which account for approximately 35% of expenditures. Data from skilled nursing facilities, hospitals, rehabilitation agencies, and comprehensive outpatient rehabilitation facilities, which account for the remaining 65% of expenditures, were not taken into account. And, CMS excluded all dates of service during which one unit of service is billed, further skewing the data on which this policy is based.

Lastly, the final fee schedule rule includes several other provisions important to physical therapists, including the implementation of the $1,870 therapy cap without an exceptions process, the projected cut in the sustainable growth rate/conversion factor of approximately 30%, and the expiration of the geographical practice cost index (GPCI) floor. Also in the rule, CMS discusses options for therapy payment alternatives, quality reporting under the physician quality reporting initiative (PQRI), and application of a MPPR policy for therapy services under Medicare Part B.

APTA will work to ensure that CMS establishes payment policies that guarantee appropriate payment for the high quality services we provide our patients. The Association is committed to being a leader in policy change and in developing payment models that accurately reflect the care and treatment provided by physical therapists.

Source:
American Physical Therapy Association

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