The ACR succeeded in having the HOD adopt policy regarding the value-based modifier (VBM) and flawed drug cost attribution. The ACR-drafted Resolution 236 asked that the AMA work with CMS to modify VBM cost attribution with regard to drug costs to ensure the cost calculation does not unfairly disadvantage certain providers. The VBM will remain part of the future Merit-Based Incentive Payment System (MIPS) called for by the MACRA (H.R. 2) legislation that repealed the SGR. Our Resolution 236 was co-sponsored by the American Academy of Allergy, Asthma & Immunology (AAAAI), American Academy of Dermatology, American College of Gastroenterology and American Society of Clinical Oncology.
The reference committee heard largely supportive testimony regarding Resolution 236. Testimony noted that disparate treatment of the costs of Part B vs. Part D medications can have an unfair impact on certain physicians under VBM and result in the greater likelihood of penalties. Testimony also noted that physicians should not be forced to make drug choices that may not improve patient care because of the flawed VBM approach to drug costs. Others noted that when MIPS replaces VBM in 2019, the costs of Part D, as well as Part B, drugs will be included in the costs attributed to physicians, providing a more fair assessment. A minor amendment was offered to ensure that all drug costs would be considered. The reference committee agreed with this testimony and recommended that Resolution 236 be adopted as amended to support a more balanced playing field, and our resolution was passed by the House.
Maintenance of Certification: There were two Committee on Medical Education Reports—one on MOC and one on Maintenance of Licensure and controversy of linking this with MOC. In addition, there were six resolutions dealing with MOC that were extensively debated. We also participated in the internal medicine caucus, in which the president and executive vice president of the American College of Physicians summarized their extensive ongoing dialogue with the American Board of Internal Medicine (ABIM), and an open forum sponsored by the Pennsylvania Medical Society that also had a significant focus on concerns with ABIM. The CME report asks the American Board of Medical Specialties (ABMS) to develop “fiduciary standards” for its member boards. The policy asks the ABMS to urge full transparency related to the costs of preparing, administering, scoring and reporting MOC exams. It also seeks to ensure MOC “doesn’t lead to unintentional economic hardships.” The ACR has since issued its own physician-driven position statement on ABIM’s MOC requirements.
