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January 2011
Policy and Advocacy
IDSA Continues to Weigh In on Consultation Codes

IDSA expressed concerns about Medicare’s decision to eliminate physician payments for consultation codes during a January meeting of the Medicare Payment Advisory Commission (MedPAC).

Daniel McQuillen, MD, FIDSA, chair of IDSA’s Clinical Affairs Committee, testified on behalf of IDSA, joining representatives from several cognitive specialties. Dr. McQuillen noted the negative effect of the decision on both ID physician practices and patient access. Dr. McQuillen also mentioned the need to develop payment incentives for infection control and systems-level activities commonly overseen by infectious diseases specialists. A transcript of the meeting, including Dr. McQuillen’s testimony, is available online.

A survey by the American Medical Association found that 95 percent of ID respondents said their total revenue stream has decreased since the policy went into effect in January 2010 (see IDSA News article.) With a regulatory fix unlikely, IDSA and others who want to restore payments for consultations continue to seek a legislative remedy, which is high on IDSA’s agenda.

Other advocacy updates include:

  • In December, IDSA responded to Medicare’s release of its 2011 Physician Fee Schedule Final Rule. In its comments, the Society continued to oppose the decision to eliminate payments for consultation codes and urged Medicare to reassess its decision not to cover all preventive vaccines under Medicare Part B. See this IDSA News article for a detailed look at the payment changes in the final rule and how they will affect you.
  • The HIV Medicine Association (HIVMA) underscored the need for payment models that reflect the cost of providing chronic, complex care in recent comments to the Centers for Medicare and Medicaid Services (CMS). HIVMA also urged CMS to support a pilot under the new Center for Medicare and Medicaid Innovation to document and evaluate, in terms of patient outcomes and cost of care, the Ryan White model for patient-centered medical home care.
  • In testimony delivered in January, HIVMA urged an Institute of Medicine (IOM) committee examining Medicare reimbursement issues to consider payment mechanisms that will support the HIV medical home care model currently supported with Ryan White funding.

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