What you need to know about RUC and Medicare payment
A physician committee that contributes the key ingredient to the Medicare rate-setting process is under the spotlight. Are the accusations of price-fixing fair, and are there better alternatives?
Physicians who treat Medicare patients instinctively know that there’s a process involved in setting payment rates for services and a committee that’s responsible for helping Medicare complete the task. Lately, some industry observers have characterized the group-the American Medical Association (AMA)/Specialty Society Relative Value Scale Update
• As an obscure committee that holds three boring meetings each year to do tedious evaluations that help the Centers for Medicare and Medicaid Services (CMS) set Medicare rates for physician reimbursements; or
• As a secretive, highly politicized group that wields enormous influence over physician reimbursements-from both Medicare and private insurers-that also has conflicting interests and little oversight.
The answer might be somewhere in the middle, but it depends on who you talk to.
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