Dear Chairman Hatch and Ranking Member Wyden:
The undersigned organizations of the Alliance of Specialty Medicine (the Alliance), a coalition of medical specialty
societies representing more than 100,000 physicians and surgeons, write to urge that any end of the year
spending package or other legislation not extend the misvalued code target recapture or include any expansion
of the Medicare budget sequester beyond 2022 or possible additional cuts that could result from PAYGO
violations. While we appreciate the difficulty in obtaining appropriate offsets for this critical legislation, these
particular offsets unduly impacts specialty physicians.
The Alliance is very appreciative of the dedication of the congressional committees with Medicare jurisdiction in
crafting end of the year legislation to address Medicare extenders and other key health items. Previously, we
have expressed concerns about the misvalued code target recapture, particularly since the work to identify
potentially misvalued services is ongoing through the American Medical Association’s (AMA) Relative Value
System Update Committee (RUC) and the Centers for Medicare and Medicaid Services (CMS). The vast majority
of physician services have been reviewed,resurveyed, and revalued, overthe course of the last few years. Indeed,
these ongoing efforts have squeezed value out of most specialty codes to the point where the target set by
Congress cannot be met, resulting in reductions in the annual conversion factor for all physicians for the three
consecutive years since passage of the Achieving a Better Life Experience (ABLE) Act (P.L. 113-295). When added
to the annual two percent sequestration cut, we believe this provision is detrimental to the Medicare program
and risks inappropriately undervaluing physician services and threatening patient access to care.
The Alliance hopes to work with you to achieve an end of the year package of key health provisions that does not
include extending the misvalued code target recapture.
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