Medicare Rules Imperil Patient Care; Physicians Offer Solutions

In comments submitted to the Center for Medicare and Medicaid Services Monday, the Association of American Physicians and Surgeons (AAPS) asked for significant changes to regulations that imperil the medical care of 57 million seniors and millions more with ostensibly private insurance. 

“MACRA compliance is not compatible with patient-centered medical care,” AAPS stated.  MACRA is the acronym for the Medicare and CHIP Reauthorization Act enacted by Congress in 2015. CMS recently asked for public input on proposed changes to regulations stemming from the legislation.

Created under the guise of increasing “quality” and “value,” in practice the program penalizes doctors who fail to comply with a complex regulatory scheme that encourages rationing.  “Rather than encourage better care, it encourages physicians to avoid the sickest and poorest patients,” explains Dr. Matthew Hahn.  Dr. Hahn’s warning is backed up by an analysis of Medicare data by Chen, Epstein, and Orav, et al, published August 1 in JAMA.

AAPS comments warn of another particularly harmful aspect of MACRA, the mandated use of Electronic Health Records:

We ask that CMS consider exempting all practices from this requirement, to protect patient privacy and safety given the epidemic of data breaches and incapacitation of EHR systems by hackers and ransomware. In addition EHRs divert the physician’s attention from patient care to government recordkeeping, and there is a growing body of evidence demonstrating the medical harm caused by EHRs.

Comments by AAPS highlight solutions with the potential to save the government billions of dollars annually, while also providing greater flexibility to patients and physicians. The solutions offered by AAPS include easing rules for physicians opted out of Medicare, non-participating physicians, and their patients. AAPS also suggests a CMS pilot project to study the benefits of Medicare disenrollment.

“CMS must use all possible discretion authorized under law to free as many physicians as possible, and their patients, from this harmful over-regulation.”

The Association of American Physicians and Surgeons (AAPS) is a national organization representing physicians in virtually all specialties and every state. Founded in 1943, AAPS has the motto “omnia pro aegroto,” which means “all for the patient.”

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– Ronald Reagan