Physicians ask the CMS to cut Medicare red tape

In response to a request by the CMS to find ways to attract and retain Medicare providers, physicians want less red tape.

Doctors are asking the CMS to better synchronize policies for Medicare Advantage, Medicare fee-for-service and accountable care organizations as a way to reduce their regulatory burden.

The CMS requested the feedback in a 2018 Medicare Advantage rate notice. The agency asked for ideas on reforming rules related to benefit design, operations and protecting the doctor-patient relationships in Medicare.

HHS Secretary Tom Price, an orthopedic surgeon, has instructed the CMS to use multiple avenues to find ways to attract and retain Medicare providers. A similar inquiry was also in the proposed pay rule for inpatient hospitals released earlier this month.

The AMGA suggests the CMS should create standard rules for the three separate and distinct Medicare programs.

For example, the Medicare Advantage program allows beneficiaries to choose to enroll, while ACO beneficiaries are assigned. Another difference is that Medicare Advantage rates are based on spending in the county where the beneficiaries reside, while ACO rates are based on assigned beneficiaries' historical utilization of services.

"For providers, this reality creates significant administrative burden to fully participate in the Medicare program," the AMGA said in an April 24 letter.

Different rules for coverage, financial incentives, payment rules and quality measures compromise providers' ability to provide optimum beneficiary care, the AMGA said.

The American Academy of Family Physicians would also like more consistency in the claims review process for Medicare beneficiaries. As things are now across the three versions of Medicare, providers must deal with multiple HHS pay contractors.

"These redundant, inconsistent, and overlapping audits place an enormous and unfunded administrative burden on practicing physicians, and the AAFP urges HHS to streamline and coordinate these efforts," the AAFP said.

The CMS said it would use some of the feedback for future rulemaking and guidance.