Massachusetts Medical Society: CMS adapts payment rule in response to physician concerns

CMS adapts payment rule in response to physician concerns


What’s up in advocacy and policy

CMS adapts payment rule in response to physician concerns


The MMS and other physician groups have successfully advocated to modulate changes to the Medicare 2019 Physician Fee Schedule (PFS), its annually proposed physician payment rule. The PFS includes updates and changes to the Merit-based Incentive Payment System and APM requirements. CMS heard our concerns and preserved the billing code for the most complex patients, collapsed the billing categories into three instead of two, and delayed the implementation of these changes until 2021, allowing for analysis and comments. Further, CMS heard physicians’ calls to reduce burnout by:

  • Decreasing the administrative burden
  • Expanding virtual health visits via new covered codes for technology-based services including virtual care and remote patient monitoring
  • Outlining changes to the MIPS reporting requirements

For details, see the fact sheets on physician payment and QPP.

In August, the MMS filed comments applauding CMS’ intent to minimize the administrative burden but highlighting that the proposed rule would have involved costly changes for many physician specialties, threatening practice viability. MMS staff will continue to follow and weigh in on this issue.

News and announcements

Search underway for new editor-in-chief of NEJM 

Drazen17.jpg The Society has announced the appointment of a search committee to seek and recommend candidates to be the next editor-in-chief of the New England Journal of Medicine. NEJM Group announced in September that Jeffrey M. Drazen, MD, editor-in-chief since 2000, will retire within the next year. Dr. Drazen will continue to lead the Journal until a successor is in place. The committee will be chaired by Lynda Young, MD, past-president of the MMS. Beverly Woo, MD, of the Department of Medicine at BWH and a faculty member at HMS, is vice-chair. Both serve on the Society’s Committee on Publications. For more information, click the button below.


Extortion scam targeting DEA registrants 

The Drug Enforcement Administration is again warning physicians that DEA registrants are receiving calls and emails from criminals identifying themselves as DEA employees or other law enforcement personnel. The criminals have masked their telephone number on caller ID by showing the DEA Registration Support 800 number. Please be aware that a DEA employee would not contact a registrant and demand money or threaten to suspend a registrant’s DEA registration. If you are contacted in this way, please report it via the DEA Diversion Control Division’s website, For more information, click the button below.


Forum: Economic impact of the opioid epidemic (Nov 16) 

This half-day Boston forum — The Massachusetts Opioid Epidemic: An Issue of Substance — will feature Michael Botticelli, executive director of the Grayken Center for Addiction at BMC, and Kaime Mahaniah, MD, CEO / CMO of Lynn Community Health Center. Other speakers and panelists include Governor Charlie Baker, Attorney General Maura Healey, and Secretary of Health and Human Services Marylou Sudders. Two panels explore the frontlines of clinical care and how to channel resources. The event is organized by the Massachusetts Taxpayers Foundation. Click the button below for information and registration.


Save the date: Evolving Models for Sustainable Medical Practice conference (Feb 2)

The conference will explore varying types of independent or private practice models and ways to align their operations and tools with market trends and priorities. It is designed to educate physicians about the variety of practice options that are available, the benefits of private practice for patient care outcomes and physician and patient satisfaction, and how to support legal and regulatory mechanisms to increase the number of private practices in Massachusetts. Barbara L. McAneny, MD, president of the AMA, is the keynote speaker. The event is organized by the MMS Committee on the Sustainability of Private Practice and will be held at MMS Headquarters, Waltham.

Health insurance marketplace calculator for 2019

The Health Insurance Marketplace Calculator from the Kaiser Family Foundation now includes local data on the 2019 health plans being sold through the ACA marketplaces during the 2019 open enrollment period. With the tool, consumers can generate estimates of their insurance premiums and what financial help may be available for ACA marketplace plans. The calculator also helps consumers determine whether they could be eligible for Medicaid. A  Spanish-language version is available. KFF also offers a searchable collection of  300+ FAQs about open enrollment, the marketplaces, and the ACA.


Video: Universal Health Care conference

Did you miss our conference on Universal Health care last month? Catch up via our videos of presentations — from leading physicians, analysts, and advocates — exploring what's next for the ACA and for health care policy overall, the pros and cons of a dramatic move to a single-payer option versus incremental reform, lessons from state-level innovations, and how this may play out in the 2018 and 2020 elections.

Evolution of public health through the stories of MMS past presidents: Clean water

LeonardMorse_pastpres.PNG “What we recognized is that drinking water lines have to be a dedicated water line. They cannot be interrupted. So we changed public health law with that, absolutely.”

— Leonard J. Morse, MD, on the 1969 outbreak of Hepatitis A among the Holy Cross football team, a virus was contracted through a contaminated faucet on a practice field, ending the season after two games. Dr. Morse, an internist in Worcester and later the city’s Commissioner of Public Health, was among the investigating physicians.  

This series of video interviews with MMS past presidents illuminates the evolution of the medical practice and profession, and public health, over recent decades.


Get involved

Wanted: MMS Senior Volunteer Physician of the Year nominations (Dec 7)


Do you know a MMS member age 60 or older who deserves to be recognized for volunteer efforts involving direct patient care in Massachusetts? See the criteria and nomination form; due Friday, December 7. 

Other award nominations are due imminently; click the button below for details:


Renew your membership

In the spirit of thanks to MMS members

A special thanks to all our members who have renewed for 2019. At a time of rapid change in health care, you are helping promote sound and sustainable medical care and public health in the Commonwealth. Avoid the holiday madness by renewing your membership with MMS today. (It takes just 4 minutes.) Go to


Reminders: Stuff you should click on

Interim Meeting updates and nudges (Nov 30, Dec 1)

The  2018 Interim Meeting of the House of Delegates will be held Friday, November 30, at MMS Headquarters, and Saturday, December 1, at the Westin Hotel, Waltham. 

  • Registration is open 
  • The Delegates’ Handbook will  post online on Tuesday, November 6, and online testimony will open

Full  meeting details are online.


Symposium for neonatal and perinatal providers (Nov 16)

Join your colleagues for lectures and workshops at the 19th Braden E. Griffin, MD, Memorial Symposium, a one-day event for neonatal and perinatal providers. The John Figgis Jewett, MD, Lectureship, sponsored by the MMS Committee on Maternal and Perinatal Welfare, will cover “A second life: microbe–human interactions beginning in infancy.” The event is provided by UMass Memorial Children's Medical Center. Click the button for more information.


Med Moth showcases medics' storytelling talents at UMass

Crowds turned out for the Med Moth at UMass Medical School this week, an event adapated from the Moth storytelling radio show and podcast. The Med Moth was designed for telling stories that serve as teaching moments of the humanity of the medical profession and the diversity of patients and colleagues. Speakers included students and faculty from the medical and nursing schools. The event was a creative use of MMS funding, which the four medical schools receive annually to hold student events or co-sponsor events on their campuses.

Educational programs and events

Live events

2018 Annual Oration: The Beneficial Effects of the 100-year-old BCG Vaccine in Type 1 Diabetes
Friday, November 30, 2018, 2:00 – 3:00 p.m. 

Ethics Forum: Health Care as a Basic Human Right
Friday, November 30, 2018, 3:30 – 6:30 p.m.

More live CME

Featured online CME: Firearm Safety

Talking to Patients about Gun Safety

Firearm Violence: Policy, Prevention, and Public Health (6 Modules) 

Initiating a Conversation with Patients on Gun Safety

More online CME

Quote of the week

“You can’t on one hand say we should talk to each other, and then I don’t talk to him. So you lead by example, and I’m the leader of the hospital.”

— Dr. Jeffrey C. Cohen, president of Allegheny General Hospital, on treating the anti-Semitic mass killer (Washington Post)

Tweet of the Week

Fatima Cody Stanford, MD, MPH, MPA, FAAP, FACP
@obesity medicine
Physician, Policy Maker, Researcher, Speaker, Media Professional 
@MassGeneral  @HarvardMed

What’s new in health care

Check out the most clicked-on stories from this week's MMS Media Watch. Sign up for daily Massachusetts media roundups by email. Some publications are fully accessible only to their subscribers.

MGH doctor says she was racially profiled on Delta flight to Boston (Boston Globe)

Dr. Fatima Cody Stanford was on Delta Flight 5935 flying from Indianapolis to Boston Tuesday night after a business meeting when the woman next her started to convulse and hyperventilate. Stanford, an obesity medicine physician scientist, educator, and policy maker at Massachusetts General Hospital and Harvard Medical School, said her first instinct was to figure out how best to help the passenger

Colleagues call for change in wake of racial profiling of Boston doctor (NBC 10)

"She is a highly sought after, highly talented physician," said Dr. Michael Sinha, a research fellow at Harvard Medical School. "She has two residencies and two fellowships under her belt." Sinha is an advocate for gender equity with degrees in medicine and law who works with Stanford through the American Medical Association and the Massachusetts Medical Society. "Myself and a couple of my colleagues really want this to become a national issue and to have this conversation again," he said.

WBUR poll: Most voters oppose ballot question about nurse staffing (WBUR)

The "no" side leads by 27 points in the new WBUR poll and by the same margin in a Boston Globe poll published earlier this week. That's a big swing since last month, when a WBUR poll showed a dead heat, and a Globe poll had the "yes" camp in front by 19 points. One major development is voters now have a better sense of the price tag. At the time of the earlier surveys, voters had only the wildly different estimates of the opposing sides.

Reports: athenahealth in talks to be acquired by Veritas and Elliott (BBJ)

Private equity firm Veritas Capital and activist hedge fund Elliott Management are reportedly in advanced talks to acquire Watertown-based health care IT company athenahealth Inc. for an undisclosed price. Bloomberg and Reuters each reported on the deal talks Wednesday, citing anonymous sources. According to the Bloomberg report, Elliott would increase its stake in athenahealth (Nasdaq: ATHN) through the deal. 

Blue Cross wants to reward hospitals for keeping patients out of hospitals (Globe)

Massachusetts' largest health insurer is trying a new strategy to tackle health care costs: put hospitals on a budget. Blue Cross Blue Shield of Massachusetts will announce Tuesday that it is developing a program to pay hospitals not for every patient they admit and every procedure they do, but for how well they control costs while helping to keep patients healthy. Hospitals would be rewarded when they collaborate with physician groups — even physicians affiliated with a different hospital — to manage costs and improve patient outcomes. 

$3M grant will help stem N.H.-Mass. drug flow (Boston Herald)

The Attorney General has led a number of initiatives in her first term related to combating the crisis, including negotiating with the makers of naloxone, the life-saving drug that can reverse the effects of a opioid overdose, to lower the cost. She was the first to propose making the trafficking of fentanyl a crime, and helped put an end to doctors who were prescribing illegal amounts of opioids and in some cases taking cash instead of Medicaid. Healey's office worked with the legislation, Gov. Charlie Baker and the Massachusetts Medical Society to change the law around prescribing and dosing practices. 

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