The American Medical Association (AMA), along with state and national medical specialty societies, have sent a letter to the Centers for Medicare & Medicaid Services (CMS) expressing serious concern about an onslaught of overlapping regulations that affect physicians. Programs with overlapping timelines include the value-based modifier, penalties under the e-prescribing program, physician quality reporting system (PQRS) and EHR incentive program, along with the transition to ICD-10.

“We urge CMS to re-evaluate the penalty timelines associated with these programs and examine the administrative and financial burdens and intersection of these various federal regulatory programs,” the letter read. “We also urge CMS to use its discretionary authority provided by Congress under these programs to develop solutions for synchronizing these programs to minimize burdens to physician practices, and propose these solutions in the physician fee schedule proposed rule for calendar year 2013.”  

“Facing all of these deadlines at once is overwhelming to physicians, whose top priority is patients,” said AMA President-elect Jeremy Lazarus, MD.

The letter asked that CMS, in the physician fee schedule proposed rule for calendar year 2013, discontinue its plans to back-date penalty programs, while synchronizing the incentive and penalty programs so that physicians who successfully participate in one program are protected from penalties associated with the other programs. 

“Relief from this back-dating policy will also avoid the reality that physicians could receive an incentive payment and a penalty in the same year for the same program, which undermines any incentive for greater reporting or use of health IT,” the letter read, adding CMS should establish in the proposed rule exemption categories to protect physicians facing hardships from penalties. 

“Finally, we emphasize to CMS our view that a strong appeals process for application of penalties to physicians under all programs is critical,” the letter concluded. “Experience with the PQRS and e-prescribing has shown the myriad of problems in determining successful physician participation, which results in physicians being incorrectly penalized, as we are seeing with e-prescribing. We urge CMS to ensure this does not occur under any of these programs.”