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MSMS Raises Member Concerns on Administrative Burdens and Increased Regulation with CMS

MSMS Raises Member Concerns on Administrative Burdens and Increased Regulation with CMS

Wednesday, May 22, 2019

The Michigan State Medical Society (MSMS) met with key Centers for Medicare and Medicaid Services (CMS) staff at the Region V Office in Chicago this week. The meeting provided MSMS and other medical societies, hospital associations, and Medicare Administrative Contractors (MAC) from Region V states the opportunity to network and learn more about upcoming CMS programs and policies. Additionally, MSMS and the other associations were able to share with CMS many of the challenges and frustrations voiced by our respective members pertaining to administrative burdens and increased regulation.

While addressing the group, Douglas O’Brien, Regional Director of the US Department of Health and Human Services for Region V, stated that “facilitating solutions for stakeholders” is a key goal of the regional offices.

Key highlights of the meeting included:

  • Presentation by Regional Health Administrator, CAPT Josh Devine, on the CMS Artificial Intelligence (AI) Health Outcomes Challenge and the Emergency Triage, Treat, and Transport (ET3) model designed to enable beneficiaries to access the most appropriate emergency services at the right time and place. Also, MSMS staff had the opportunity to “toot MSMS’ horn” during discussion of CMS’ efforts regarding pre-diabetes services and care. MSMS, in collaboration with the American Medical Association and Michigan Department of Health and Human Services, assisted several Michigan Physician Organizations to implement the National Diabetes Prevention Program. The roll-out over the past four years has been touted as a national model.
  • Presentations by Chief Medical Officers Patricia Meier, MD, and David Nilasena, MD, on several CMS initiatives including the recently announced Primary Care First and Direct Contracting payment models, Patients over Paperwork, price transparency, interoperability, E/M changes, Quality Payment Program, CMS Opioid Initiative, and rural health focus. Physicians can send suggestions to CMS about how to streamline regulations and operations with the goal of reducing unnecessary burden, increasing efficiencies and improving the customer experience are being accepted at
  • Overview of collaborative efforts by the MACs (NCG, CGS, and WPS GHA), as well as a questions and answers session. WPS GHA is the MAC for Michigan.
  • Preview of new beneficiary e-Medicare tools designed to help Medicare beneficiaries and those who help them easily find and enroll in coverage that meets their needs including an Out-Of-Pocket estimator to show how coverage choices between original Medicare and Medicare Advantage affect out-of-pocket costs.

Throughout the day, MSMS continued to stress the need for more alignment and simplification among federal, state, and commercial payer quality initiatives, as well as the importance of physician input during the design, decision-making, and roll-out of new initiatives.

These opportunities to network and build relationships with CMS and MAC representatives have proved valuable in helping to address both individual and statewide MSMS member concerns with CMS policies and actions.