Federal Regulator, Meet Dr. Regulated

Joe Cantlupe, for HealthLeaders Media , July 25, 2013

Increased technology improvements over time should have reduced the amount of time doctors needed for such procedures, but that hasn't been reflected in the pay, the Post asserts. Between 2003 and 2013, the Post wrote, "AMA and Medicare have increased the work values for 68% of the 5,700 codes analyzed by the Post, while decreasing them for only 10%."

While the Post has called the RUC, a secretive committee, the AMA has disputed the claim, as well as many other elements of the newspaper's story. For instance, the AMA stated that it was untrue that relative values have primarily increased since 2003, leading to an increase in Medicare spending. In addition, the AMA asserted that its committee "has worked vigorously over the past several years to identify and address (misevaluations) in the RBRVs (Resource-Based Relative Value Scale) through provision of revised physician time data and resource cost recommendations to CMS." The RBRV is used to determine how much providers are paid.

Evaluation of pay scales are constantly monitored, the AMA states. "The committee fully acknowledges that there are services that are now performed more efficiently and these codes have been or will be addressed." For instance, the time and valuation for cataract surgery was significantly reduced in 2013. About 500 physician services have been decreased, redistributing $2.5 billion to primary care and other physician services, the AMA said. While the AMA issued a "background" statement, no official was named to provide details of the AMA response.

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