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- Sep 27, 2004
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Here is the text of an email I just got from the CAP. Everyone can stop crapping their pants now.
At a meeting today of the Physician Payment Advisory Commission (PPAC), CMS officials said that the current Medically Unbelievable Edits (MUE) proposal is no longer scheduled to be implemented in July as previously planned. The proposal will be revised and re-submitted for public review and comment. This announcement followed concerns raised by the Chairman of the Physician Payment Advisory Commission Dr. Ronald Castellanos who stated that the current edits could have significant negative impacts on patient care. Testifying before the Commission was Dr. William Rogers, who stated that he had learned about the problems with the current MUE proposal from the College of American Pathologists in a meeting last week. He had discussed these concerns with the MUE Project manager at CMS.
The PPAC recommended "the CMS withdraw the proposal to create a list of MUEs and resubmit through the normal rulemaking process and to work closely with the medical community in this effort." The motion was unanimously accepted.
The CMS decision to withdraw the MUE proposal comes in direct response to an intense lobbying campaign by a CAP-led coalition of national and state pathology societies. The AMA, numerous medical specialty societies, and the American Clinical Laboratory Association (ACLA) also strongly advocated for the withdrawal of the MUE proposal.
The College and its coalition partners have pressed CMS to withdraw the MUE proposal and have argued that the agency should be required to utilize the formal rulemaking process to develop sweeping unit of service limits on all pathology and clinical laboratory services. The College has also asked the agency to provide the rationale and methodology utilized to develop the MUE proposal.
Since CMS' decision in fall 2004 to move forward with cytology PT, the College has argued strenuously for a review of the program, saying improvements in cytology science and practice have long since passed by the PT regulation's 13-year-old grading scheme. The College also contends that various other aspects of the PT program, including its emphasis on individual testing, annual schedule and escalating penalties, conflict with either the letter or spirit of the original CLIA law.
The new approach will hopefully yield a more rational proposal and will also allow medical societies sufficient time to provide a strong evidence based response to whatever proposal may re-emerge.
We are awaiting a written notification from the contractor withdrawing the proposal. CAP will continue to keep members informed on further details of CMS's plans in this area.
The PPAC recommended "the CMS withdraw the proposal to create a list of MUEs and resubmit through the normal rulemaking process and to work closely with the medical community in this effort." The motion was unanimously accepted.
The CMS decision to withdraw the MUE proposal comes in direct response to an intense lobbying campaign by a CAP-led coalition of national and state pathology societies. The AMA, numerous medical specialty societies, and the American Clinical Laboratory Association (ACLA) also strongly advocated for the withdrawal of the MUE proposal.
The College and its coalition partners have pressed CMS to withdraw the MUE proposal and have argued that the agency should be required to utilize the formal rulemaking process to develop sweeping unit of service limits on all pathology and clinical laboratory services. The College has also asked the agency to provide the rationale and methodology utilized to develop the MUE proposal.
Since CMS' decision in fall 2004 to move forward with cytology PT, the College has argued strenuously for a review of the program, saying improvements in cytology science and practice have long since passed by the PT regulation's 13-year-old grading scheme. The College also contends that various other aspects of the PT program, including its emphasis on individual testing, annual schedule and escalating penalties, conflict with either the letter or spirit of the original CLIA law.
The new approach will hopefully yield a more rational proposal and will also allow medical societies sufficient time to provide a strong evidence based response to whatever proposal may re-emerge.
We are awaiting a written notification from the contractor withdrawing the proposal. CAP will continue to keep members informed on further details of CMS's plans in this area.