AAFP Addresses RUC Subcommittee Regarding Changes the Academy Seeks

AAFP Board Chair Roland Goertz, M.D., M.B.A., of Waco, Texas, hopped a plane to Chicago recently to take the Academy's argument for changes to the AMA/Specialty Society Relative Value Scale Update Committee, better known as the RUC, straight to the group's administrative subcommittee.

Earlier this summer, the Academy called on the RUC to make some very specific changes to its structure, process and procedures. After receiving the AAFP's June 10 letter, the RUC invited the Academy to further explain its position.

Goertz spoke with AAFP News Now shortly after his Sept. 22 presentation to the RUC subcommittee. He called the meeting "a positive exchange of information."

"I was allowed to make a statement to clarify our request," said Goertz, adding that his 10-minute presentation was followed by a 50-minute question-and-answer session.

"Without telling the RUC exactly which path to take, I think we have made our case. Now it's up to them," said Goertz.

The RUC acts as an expert panel and makes recommendations to CMS on the relative values of CPT codes, which determine what physicians are paid for the services they deliver to patients. The Academy and other primary care physician organizations have made no secret of their belief that decisions made by the RUC favor subspecialist procedures rather than preventive care and chronic disease management services.

The AAFP's stance was summed up in that June letter to RUC Chair Barbara Levy, M.D., in which the Academy made five specific requests, asking the committee to

In addition to Goertz, three other Academy members took part in the recent Chicago meeting: Walter Larimore, M.D., of Monument, Colo.,who currently serves as the AAFP's representative to the RUC; Lee Mills, M.D., of Newton, Kan., who is the alternate representative, and Thomas Weida, M.D., of Hershey, Pa., who is the AAFP's RUC adviser.

None of the family physicians in attendance was able to provide any detail about the meeting's proceedings because of the RUC's stringent confidentiality agreements.

However, Goertz did say he was "cordially received" by the subcommittee members and that each of the Academy's five issues was addressed. "On every issue, there were questions related to clarifications, which I did my best to provide," said Goertz.

"When they excused me from the room, they began the serious deliberation of the five requests that we made of them," Goertz said, adding that even though he doesn't anticipate a formal answer to the requests immediately, "I do have every reason to believe that they will answer our request by the March (1, 2012) date we have given them."

Regarding the Academy's next move, Goertz said, "I don't believe that there are any other action steps that we can take at this time.

"We've done everything that is reasonable to make our case, and, at least to this point, we've been heard."