Administrative Simplification

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Overview of Administrative Simplification

Administrative simplification represents an industry-wide commitment to reducing health care costs by strengthening the electronic exchange of data, and by removing unnecessary burdens throughout the compliance, claims and billing processes. The AAFP supports these objectives and is continuously working to alleviate demands placed on family physicians through entangling paperwork and needless regulatory complexities. The U.S. health care system can and must do better and the AAFP continues to work with Congress, regulators and private payors to create policies that promote the delivery of quality health care by focusing on the patient and not the paperwork.

The AAFP has advocated for expedited implementation of administrative simplification provisions in federal and state regulations that will enhance meaningful electronic communications between health plans, financial institutions and family physician practices.

We also have pushed for the elimination of aspects of the Medicare and Medicaid programs that are unnecessary, obsolete, or excessively burdensome for health care providers and beneficiaries. Specifically, we have supported the elimination of:  

  • Provisions that preclude Medicare and Medicaid re-enrollment for physicians who have not responded in a timely manner to revalidation queries of the Centers for Medicare & Medicaid Services (CMS);
  • The current Medicare rule that automatically deactivates a physician who has not submitted a Medicare claim for 12 consecutive months.

Family physician practices continue to be deeply overburdened by administrative functions at the point of care and after patient care hours. The volume of administrative and regulatory functions required of physicians continues to be compounded by the lack of harmonization in these functions across payers. The AAFP and other organizations developed joint principles on reducing administrative burden in healthcare and continue to urge CMS to closely consult, adopt, and adhere to these principles. The AAFP is determined to help family physicians reduce these roadblocks by identifying and eliminating regulations and processes that add cost while undermining the efficient and effective delivery of quality care.

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