Congress Mobilizes Against Proposed E/M Changes

A massive surge in opposition to the Centers for Medicare & Medicaid Services’ proposed simplification of its physician-provided office visits policy is sweeping through Congress. CMS is proposing a collapse of today’s four E/M codes into just one.

But a bipartisan group of 90 in Congress is now urging the agency to revisit this course. This adds important clout to the Academy’s opposition to the change, which we believe should not be done while linked with other payment policy adjustments. It’s timely support, too; CMS Administrator Seema Verma indicated this week that she’s open to changing the policy to address the widespread opposition.

The proposed E/M change was among the biggest developments in the draft Medicare fee schedule rule, intended to reduce burdens on physicians. The Academy objected to the proposal, meeting directly with CMS Administrator Seema Verma as part of a strong, medicine-spanning coalition of likeminded stakeholders. During this time, we’ve raised the issue with many in Congress.

Verma’s position on the E/M change is in flux following Congress’ intervention. She indicated to several media outlets this week that she is weighing several suggestions that could improve the well-intentioned proposal.

The Academy believes that the proposed collapse-and-reduction of four visit levels into one clearly causes an unacceptable loss of recognition of care levels.