Bucshon opposes proposed Medicare rule

U.S. Reps. Larry Bucshon (R-IN) and Ami Bera (D-CA), both physicians, along with 24 Republican colleagues, strongly oppose a provision in the 2020 Medicare Physician Fee Schedule proposed rule that would not include the adjusted values for the revised office/outpatient evaluation and management (E/M) codes in the global surgery codes.

“Patients’ access to high-quality care must be at the forefront of all health care policy decisions,” Rep. Bucshon said on Oct. 3. “While I’m pleased that CMS [Centers for Medicare and Medicaid Services] updated the standalone office/outpatient evaluation and management codes, I’m disappointed that they failed to also include updates to the global surgery codes.”

In the 2020 Medicare Physician Fee Schedule proposed rule, CMS proposed adjusting certain E/M codes for office/outpatient procedures while not adjusting the E/M portion of global codes, according to Rep. Bucshon’s office, which noted that without including global codes in this rule, physicians cannot be paid the same rates for services rendered to patients under Medicare.

“We believe that CMS is arbitrarily implementing the E/M adjustments in a manner that runs counter to current law,” according to a Sept. 27 letter Rep. Bucshon and his colleagues sent to CMS Administrator Seema Verma. “Should CMS finalize its proposal to adjust the office/outpatient E/M code values, the agency must also apply these updated values to the global codes.”

The lawmakers also said the Medicare statute specifically prohibits CMS from paying physicians differently for the same work, “and the ‘Secretary may not vary the … number of relative value units for a physicians’ service based on whether the physician furnishing the service is a specialist or based on the type of specialty of the physician,’” according to their letter. “Failing to adjust the global codes as proposed is equivalent to paying some physicians less for providing the same E/M services.”

The congressman said that he “was happy to co-lead this letter to Administrator Verma, urging the administration to incorporate the adjustments proposed into the global surgery codes as well, so that specialty differentials are not created and patients continue to have access to the care they need.”

Among the lawmakers who joined Rep. Bucshon in signing the letter were U.S. Reps. Brad Wenstrup (R-OH), Brian Fitzpatrick (R-PA) and Jackie Walorski (R-IN).