Overview of the Practice Management Committee
Government Relations and Practice Management Committees Working Together
2009 PMC Leadership Report
2008 PMC Leadership Report
Practice Management Committee’s Mission Statement: To provide resources, advocacy, and education for efficient practice management for optimal patient care.
The Practice Management Committee (PMC) is charged with the following:
In addition to the above charges, the PMC works closely with two ACCP NetWorks. The Practice Administration NetWork provides expertise in health information technology, coding, and reimbursement and business of medical offices. The Private Practice NetWork helps identify physician experts in practice management and identify and mentor future leaders in the Practice Management arena. The collaboration between the Practice Management Committee and the two NetWorks greatly increases the overall practice management efforts of the ACCP and strengthens the development of the Practice Management Department.
Furthermore, the PMC works in conjunction with the ACCP Government Relations Committee (GRC) on advocacy issues relevant to pulmonary, critical care, and sleep medicine (ie, Pulmonary rehab legislation, critical care workforce issues, SGR).
Eligibility Criteria:
Responsibilities of PMC Members:
All applicants should submit the materials listed below to Marla Brichta, Assistant VP of Health Affairs at mbrichta@chestnet.org or fax: (847) 498-5460.
CAC Background Information: Medicare Administrative Contractors (MACs) must establish one Contractor Advisory Committee (CAC) per state, comprising physicians representing various medical specialty societies. The CAC assists the MACs in development of Local Coverage Determinations (LCDs) and discusses other relevant medical issues presented in their state.
The purpose of the ACCP CAC is the following: To provide a formal mechanism for ACCP pulmonary, critical care, and sleep physicians in each state to be informed of and participate in the development of an LCD in an advisory capacity. To provide a mechanism to discuss and improve administrative policies that are within contractor discretion. To provide ACCP members a forum for information exchange between contractors and physicians.
The ACCP CAC Representative is charged with the following: To improve the relations and communication between Medicare Contractor Medical Directors and the ACCP members. To disseminate proposed LCDs to colleagues in their respective state and specialty societies to solicit comments. To disseminate information about the Medicare program obtained at CAC meetings to their respective state and specialty societies. To provide a consensus recommendation approved by the ACCP Practice Management Committee (and the Board, when appropriate) for proposed LCD revisions. To discuss inconsistent or conflicting medical review policies.
Eligibility Criteria: Candidates for appointment must be ACCP members in good standing. Knowledge of coding and reimbursement, practice management, and/or coverage issues is helpful. Must be willing to participate in the process outlined below.
Responsibilities of the CAC Representative:
To participate in the three, 1-hour, ACCP CAC conference calls and one face-to-face meeting at CHEST, as well as actively participate in his or her state’s MAC CAC meetings with his or her contractor and attend a minimum of two meetings annually. To participate in subcommittees or ad hoc workgroups and similar projects, if asked by the Chair of the pulmonary CAC that would either meet at the three meetings or via scheduled conference calls. To provide advice and educate pulmonary, critical care, and sleep physicians in his or her state on CAC issues of interest. To work together on the development of comment letters (often coordinated by both ACCP, ATS, and other pulmonary groups) to contractors/CMS on issues of interest to pulmonary, critical care, and sleep medicine health professionals. To be a trusted resource for contractors in each state on pulmonary, critical care, and sleep-related payment issues. To actively participate in the AMA Relative Value System Committee (RUC) survey process for new and revised pulmonary, critical care, and sleep medicine codes, when requested. The ACCP Practice Management Committee is responsible for generating relative value recommendations using the AMA survey method and identifying relevant practice expense inputs. Survey methods, details, and materials are developed by the AMA staff, in cooperation with specialty staff, and approved by the RUC.
To participate in the three, 1-hour, ACCP CAC conference calls and one face-to-face meeting at CHEST, as well as actively participate in his or her state’s MAC CAC meetings with his or her contractor and attend a minimum of two meetings annually.
To participate in subcommittees or ad hoc workgroups and similar projects, if asked by the Chair of the pulmonary CAC that would either meet at the three meetings or via scheduled conference calls.
To provide advice and educate pulmonary, critical care, and sleep physicians in his or her state on CAC issues of interest.
To work together on the development of comment letters (often coordinated by both ACCP, ATS, and other pulmonary groups) to contractors/CMS on issues of interest to pulmonary, critical care, and sleep medicine health professionals.
To be a trusted resource for contractors in each state on pulmonary, critical care, and sleep-related payment issues.
To actively participate in the AMA Relative Value System Committee (RUC) survey process for new and revised pulmonary, critical care, and sleep medicine codes, when requested. The ACCP Practice Management Committee is responsible for generating relative value recommendations using the AMA survey method and identifying relevant practice expense inputs. Survey methods, details, and materials are developed by the AMA staff, in cooperation with specialty staff, and approved by the RUC.
Applicants should submit the materials listed below to Marla Brichta, Assistant VP of Health Affairs (e-mail: mbrichta@chestnet.org or fax: (847) 498-5460).
Mission Statement of the Practice Management Committee To provide resources, advocacy, and education for efficient practice management for optimal patient care.
RUC: The RUC is a unique multispecialty American Medical Association (AMA) committee dedicated to making relative value recommendations for new and revised codes, as well as annual RVU updates to reflect changes in medical service. One physician representative is appointed from each of the 114 specialty societies seated in the AMA House of Delegates to serve on the advisory committee to the RUC. Advisors are nominated by the specialty society they represent.
The ACCP RUC Advisor is charged with the following:
Responsibilities of the RUC Advisor:
CPT: Current Procedural Terminology (CPT) is a listing of descriptive terms and identifying codes for reporting medical services and procedures.
The purpose of the American Medical Association (AMA) CPT is the following: To provide a uniform language that accurately describes medical, surgical, and diagnostic services and, thereby, serve as an effective means for reliable nationwide communication among physicians and other health-care providers, patients, and third party insurance companies.
The ACCP CPT Advisor is charged with the following:
Responsibilities of the CPT Advisor:
The American College of Chest Physician (ACCP) and the American Thoracic Society (ATS) work together at the national level on coding and reimbursement issues through the ACCP Practice Management Committee and the ATS Clinical Practice Committee. Major decisions are reviewed and approved by the ACCP and ATS Board leadership. The ACCP and ATS are actively involved in developing American Medical Association (AMA) Current Procedural Terminology (CPT) proposals for new or revised procedure or service codes relevant to pulmonary, critical care, and sleep medicine.
The ability to obtain new codes has evolved through early communication with industry and provision of frequent guidance on issues pertinent to reimbursement. Often, these aspects are not inherent in processes involved in FDA approval. Additionally, data necessary for optimizing reimbursement for practitioners may not be considered when developing efficacy and safety studies to support widespread clinical use of new technology. These components of the process are aspects for which the pulmonary societies are able to confer expertise. We actively work with sister societies, such as SCCM, AARC, and NAMDRC, on relevant issues.
To facilitate communication with industry, we have outlined required information the ACCP and ATS need to assist in the reimbursement process. We recognize that the phase of development of technology will vary and not accommodate the ability to provide all of this information initially. For these projects, we are able to provide guidance as the development matures. However, all should recognize that, ultimately, this information is needed when attempting to obtain a CPT code and the reimbursement associated with its use. The ACCP and ATS are prepared to assist companies desirous of proceeding along these lines at any step of their development. To prepare our CPT advisors with the necessary defense to support new procedures, the ACCP and ATS work through their committees, networks, and institutes to solicit input from individuals who are disconnected from the development process, however, are considered experts in the area under consideration. Although this critical review of the new technology may appear onerous, the CPT and RUC process will engender this debate, and our organization recognizes this exercise facilitates preparing the best proposal. The following reflects our guidelines for assisting with this process. Industry should not contact the ACCP or ATS CPT and/or RUC advisors or members of the ACCP Practice Management Committee or the ATS Clinical Practice Committee directly to lobby for CPT proposals. Initial contact requesting this help should be directed to Diane Krier- Morrow at dkriermorr@aol.com
To view the AMA's calendar of CPT and RUC meetings and deadlines go to: http://www.ama-assn.org/ama1/pub/upload/mm/362/calendar2007-09.pdf
Information Requested From Industry To Facilitate Pulmonary Review of CPT Code(s) and Reimbursement
For questions, contact: Diane Krier-Morrow, MBA, MPH, CCS-P American College of Chest Physicians (ACCP) and the American Thoracic Society (ATS) (847) 677-9464 dkriermorr@aol.com