[MMA News Now, September 2, 2010] The American Medical Association (AMA) has issued its recommendations on the Center for Medicare and Medicaid Services’ (CMS) proposed physician fee schedule for 2011. Here are some of the AMA’s principal recommendations.

The AMA is in favor of a comprehensive review of the Medicare Economic Index (MEI) but cautions that CMS should not make any changes to the MEI for 2011 until this review has been finished. The MEI should be updated to better reflect the financial realities of practicing medicine in the 21st century.

The AMA also recommends that CMS revise the Physician Quality Reporting Initiative (PQRI) feedback report proposal. Furthermore, the AMA believes that CMS needs to improve the PQRI appeals process by adding more telephone lines and more trained, experienced staff to the Quality Net Help Desk. Additionally the AMA agrees with CMS’ decision to reduce the PQRI reporting sample requirement from 80 percent to 50 percent in 2011. However, the AMA strongly suggests that CMS apply this 50 percent threshold retrospectively to the 2010 year, as well. Finally, the AMA notes that it is important for CMS to offer detailed specifications about individual measures and group measures for the November 15, 2010, PQRI.

CMS’ proposed e-prescribing requirements for 2011, which call for physicians to report on only twenty-five services involving e-prescriptions, have gained the support of the AMA. However, the AMA is opposed to the imposition of financial penalties in 2012 and 2013 based on physicians’ e-prescribing activity in the first half of 2011. Rather, the AMA believes that any penalties assessed in 2012 or 2013 should be based on e-prescribing activity from that same fiscal year. Furthermore, CMS should offer more exception categories for physicians facing hardships that would make them eligible to be exempted from e-prescribing penalties in 2012 and 2013. Finally, the AMA suggests that CMS adopt an appeals process to allow physicians to appeal decisions that would influence their ability to either participate in the e-prescribing program or affect their ability to receive e-prescribing incentives.

The AMA’s full letter to CMS Administrator Donald Berwick, M.D. can be read here.