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Affordable Care Act Cuts Out Physician Input

Posted Nov 27 2010 8:08am
Secretary of HHS Given Full Discretion over Fees and Reimbursement

Practicing Physicians Advisory Council is discontinued in Health Reform Bill

It would appear, that the more we learn about the new health reform bill, the more we have to be concerned about.   In a brief sentence, deep within the bill, we are informed that Section 1868(q) of the Social Security Act (42 U.S.C. 1395ee(A) is repealed. 1

Well, now just who would know what that is all about?   It seems that Congress at one time, felt it important that a panel of PRACTICING physicians, who actually live and work under the payment rules of Medicare, should get together quarterly, to discuss with HHS and CMS issues related to billing, coding and reimbursement. The common sense behind this makes one wonder how Congress ever came up with this in the first place.  

When one goes to the CMS site to review this topic, one finds this text:

‘In accordance with H.R. 3950, section 3134(b)(2) of the Patient Protection and Affordable Care Act, repeals section 1860(a) of the Social Security Act (42 U.S.C. 1395ee(a)), which provided for the establishment of the Practicing Physicians Advisory Council (PPAC), and specified the PPAC's composition and meeting schedule. The date of enactment of this provision is March 23, 2010. Therefore, the PPAC is being discontinued and the June meeting will not be held.’ 2,3

In other words, those who wrote the health bill (now who was that?) determined that it was in the best interests of health care to eliminate any face-to-face discussion between physicians and bureaucrats at CMS. No doubt, since the health bill now gives all discretion to the Secretary of HHS in regard to determining fee related matters; it was best to remove any pesky interference.   Heaven forbid we should actually have input from doctors working in the real world, under these regulations and payment policies give any feedback.

It is exactly this kind of broad latitude given to the Secretary of HHS, in the absence of any modifying input from those actually providing care and services that has prompted concern, indeed fear, from many.   With physician shortages likely to become exacerbated by any expansion of access, the elimination of practicing physician input would seem to be unwise at best, and at worst, a designed move to eliminate objection to the likely severe cost cutting that the Secretary of HHS is going to undertake.   It has also prompted negative commentary in the media. 4

We can only hope that his provision will be removed and the input from practicing physicians will again be sought after and respected.  

1.H.R.3590- Patient Protection and Affordable Care Act -

2. Practicing Physicians Advisory Council -


4. Practicing doctors are losing a voice -

5. Affordable Care Act Cuts Out Physician Input -



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