AMA RUC to Increase its Transparency

The American Medical Association panel that recommends values for physician services to CMS for Medicare Part B payment purposes, which has been widely criticized for its closed-door process, has initiated some changes in an effort to make them more transparent. The AMA Specialty Society Relative Value Scale Update Committee, commonly known as the RUC, will now publish meeting minutes and how the panel as a whole voted for individual current procedural terminology codes; how individual members voted will not be released. The information will be posted on the AMA website after CMS releases its annual Medicare physician fee schedule. The new Medicare fee schedule typically is released around Nov. 1, but this year, because of the government shutdown, CMS announced it may not be released until Nov. 27.

Increased transparency in how physician services are valued in Medicare could have significant implications for physician payment in Medicaid and the private sector. Most commercial insurance plans set physician payment as a percentage of the Medicare physician fee schedule. Employers should take note of the increased transparency at the federal level, and advocate for similar transparency within commercial insurance plans. This increased transparency, combined with the real possibility of SGR reform in the near future, could have significant downstream impacts on the entire health care delivery system.