Doctors Sue to End AMA’s Role in Setting Medicare Payments

I’ve written about this in the past. Here’s the gist:

Imagine there is a committee of politicians made up of 24 republicans and 5 democrats. Their job is to decide a politician’s salary–for democrats and republicans–and decisions are made by majority rule. Which party do you think would have the highest salary?

Much like American politics, doctors have a two-party system. It’s the Primary Care Party versus the Specialist Party. For the past 20 years, the specialists have been pummeling the primary cares. In 1991, the AMA formed an expert committee called the RUC in response to a Congressional mandate to provide recommendations to the Center for Medicare & Medicaid Services (CMS) on the worth of every visit and procedure a doctor can perform. CMS then accepts, rejects, or modifies these recommendations and effectively places a dollar amount on the thousands of codes doctors use to get reimbursed. CMS sets the standard. Private insurers then use these standards to decide how much they reimburse physicians in their own networks.


Family doctors go after American Medical Association in hopes of ending wage disparity

Six Georgia primary care physicians have filed a lawsuit seeking to end the cozy relationship between Medicare administrators and a committee of doctors that influences the fees physicians are paid by the federal health program for the elderly.

A draft of the suit, which was obtained by iWatch News , alleges that the Centers for Medicare & Medicaid Services (CMS) and its parent agency, the Department of Health and Human Services (DHS) violate several federal laws, including the2010 Affordable Health Care Act, in relying on the American Medical Association / Specialty Society Relative Value U pdate Committee, or RUC, to value physician services paid for by Medicare.

I do hope this suit is successful and we take a first step toward ending the massive salary discrepancy between much needed primary care doctors and specialists.

Doctors Sue to End AMA’s Role in Setting Medicare Payments