Residents and Medical Students Should Support All Efforts to Revalue Cognitive Services

Denny Flint

Posted 1/25/12 on The Future of Family Medicine Blog

The numbers do not lie.  As stated in a previous post and its referenced links, the payment gap between primary care and specialists has increased since the American Medical Assocation started the Resource-Based Relative Value Scale (RVS) Update Committee (“RUC”) in the early 1990s.  It is difficult to separate the two when the Center for Medicare and Medicaid Services (“CMS”) has accepted over 90% of the RUC’s recommendations throughout the years.  This can be interpreted in a number of different ways but let’s be honest – I am a current intern and do not have enough time to go through the different interpretations –  I will leave that up to your comments.

Recently, 6 Georgia physicians led by Dr. Paul Fischer filed a lawsuit against CMS alleging that “CMS has violated federal law and the U.S. Constitution by using a panel of doctors’ recommendations (the RUC) when establishing values for Medicare-covered services.”  The suit also claims that “the agencies have functionally treated the RUC as a federal advisory committee. But they have not required the RUC to adhere to the Federal Advisory Committee Act’s (FACA) stringent management and reporting rules – e.g., balanced representation, transparent proceedings, and scientifically valid analytical methodologies – that keep the proceedings in the public interest. The plaintiffs request injunctive relief, which would freeze the relationship between CMS and the RUC until the advisory group complies with FACA’s requirement.”

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