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Physician panel prescribes the fees paid by Medicare

The Wall Street Journal, October 27, 2010

Three times a year, 29 doctors gather around a table in a hotel meeting room. Their job is an unusual one: divvying up billions of Medicare dollars.

The group, convened by the American Medical Association, has no official government standing. Members are mostly selected by medical-specialty trade groups. Anyone who attends its meetings must sign a confidentiality agreement.

Yet the influence of the secretive panel, known as the Relative Value Scale Update Committee, is enormous. The Centers for Medicare and Medicaid Services, which oversee Medicare, typically follow at least 90% of its recommendations in figuring out how much to pay doctors for their work. Medicare spends over $60 billion a year on doctors and other practitioners. Many private insurers and Medicaid programs also use the federal system in creating their own fee schedules.

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1 comments on "Physician panel prescribes the fees paid by Medicare"


AMA (10/28/2010 at 9:55 AM)
More than 300 attendees participated in the last RUC meeting and information is publicly available, including at www.ama-assn.org/go/rbrvs. The hard work of the volunteer physicians who comprise the RUC saves taxpayers millions of dollars. Bottom line: Medicare sets payment rates, RUC makes recommendations within Medicare's budget neutral constraints, where increases for one service result in across the board decreases for all services. There's no mention in this story of the fact that Medicare payments to physicians will be cut about 30 percent overall unless Congress acts by December 1 – that's the real Medicare physician payment problem lawmakers need to focus on or access to health care for seniors and baby boomers will suffer.