ACTION NEEDED:  Urge Your Members of Congress to Support E/M Wins in Final Fee Schedule Rule!

ACP is urging all of its members to actively engage with Congress in our effort to protect much-needed gains for primary and cognitive care that were included in the final physician fee schedule regulations. As announced on Nov. 1, the Centers for Medicare and Medicaid Services (CMS) finalized regulations that will go into effect in 2021 to greatly improve payments for your undervalued Evaluation and Management (E/M) services and reduce the time you must spend on unnecessary documentation. Yet efforts are being made by some physician specialties to persuade Congress to block these improvements for E/M services; it's imperative that they not succeed. We urgently need your help in reaching out to your members of Congress to urge them instead to support CMS's improvements in E/M payment and documentation.

Here's the back story. Last year, CMS decided it would pay the same flat amount for office visits levels 2 through 4, regardless of complexity, devaluing complex cognitive care. Now, in direct response to ACP advocacy, CMS has reversed itself and decided it will continue to pay appropriately more for each level of visit complexity rather than one combined flat fee. Even better, as ACP recommended, CMS agreed to increase overall payments for each office visit code, while reducing required documentation of them.  We applaud CMS for having adopted so many of ACP's recommendations (see more information below) in the final regulations.

On November 6, 2019, ACP sent a letter to the leaders of the key congressional health care committees urging that they express their support to CMS for full implementation of the final regulations. ACP has decided to pro-actively take that step in reaching out to Congress because grassroots efforts on the part of some specialty organizations are underway to block, delay, or undermine the improvements in payments and documentation for office visits, to the detriment of internal medicine physicians, family physicians, other cognitive and primary care physicians-and most importantly, your patients. Now is not the time to be complacent but rather we must advocate vigorously to ensure that the final regulations are implemented.

Action Requested:  Please send a letter to your members of Congress in both chambers urging them to advocate with CMS in support of full implementation of the 2020 physician fee schedule regulations. A sample letter has been provided for you that you can personalize. Using the "Take Action" link below, simply fill in your contact information, follow the prompts, and submit your letters electronically.

Take Action

Background: Major advocacy "wins" in the 2020 final physician fee schedule regulations include:

  1. Higher physician work RVUs for new and established office visit codes, leading to increased payments for them.  The higher work RVUs are essential and based on evidence that shows that current payment levels undervalue the complexity of physician work in providing primary and cognitive care to patients. 
  2. Reduced documentation requirements for office visit codes, which enables physicians to select and document for each visit based on medical decision-making or total time.  These changes will allow physicians to spend more time with patients and less on documentation and paperwork.

Expanded and improved payment for care management services.  Appropriate payment for care management will make it possible for physicians to coordinate care with others on the patient's clinical care team, leading to better health outcomes.

ACP Offers Resources to Help Physicians Navigate Telehealth Technology

ACP is committed to helping internists take advantage of telehealth technology to improve patient care and outcomes and offers resources breaking down a physician's telehealth options, insurance coverage, the applicable billing codes, and ACP policy guidance.

Use our calculator to conduct a cost-benefit analysis to determine whether adding telehealth will be financially feasible for your practice.

Additional resources include a CME-MOC eligible ethics case study, a white paper which offers guiding considerations and impacts of telehealth in various settings, a podcast episode on the future of telehealth, and policy recommendations.

For more information, contact Steve Majewski, Media Relations Manager, at or 800-523-1546, ext: 2514.

MLMIC’s November 2019 Case Review Now Available

The latest Case Review is available as a podcast and as a downloadable pdf.


Case Study #1    “Multiple Failures in Care Result in Neurologically Impaired Infant”

Case Study #2    “Questionable Eye Care and Records Lead to Large Settlement”

Read or listen to the latest Case Review.

Opioid and Substance Abuse Disorder Resources: NYACP Members can earn a $500 honorarium

The College has partnered with the American Academy of Addiction Psychiatry (AAAP) and a coalition of national professional organizations on two SAMHSA-funded initiatives, the Provider Clinical Support System (PCSS) and Opioid Response Network programs, to combat the opioid crisis.  As a part of these programs, ACP hosted a virtual quality improvement chronic pain leadership-training program in May of 2019, due to the success of this event, we have decided to offer a second round of training, details of which are below:

  •  A 2 hour webinar providing an overview on how to apply ACP’s QI methodology to improve chronic pain management and safe opioid prescribing on November 20, 2019.
  •  A series of 4 coaching calls with expert QI faculty to support implementation of a QI project focused on chronic pain management through January 2020.
  •  Participants will be asked to submit a summary report of program outcomes to ACP no later than January 31, 2020.

 Interested participants should apply through the following link:

  • Program Application Criteria: New participants may apply (participation in the May virtual training disqualifies you from applying again)
  • A $500 honorarium will be provided to selected participants

For more information about this opportunity, please contact Julia Thayer at

EHR’s and the Pathway to Litigation – Medical Malpractice Cases and New (Informal) Rules of Engagement

Electronic health records are quickly establishing a new pathway for litigation in the field of medical malpractice, and physicians must be aware of the pitfalls that accompany EHR use. NYACP members received two discrete warnings about this in October. One was through the presentation “Avoiding Medical Liability Suits” by Russell Corker, Esq. (The Corker Law Firm) and Will Hassett, Esq. (Fager, Amsler, Keller and Schoppmann) at the NYACP Annual Meeting, which focused on the use of EHR in trials. The other is through the lead article in the MLMIC Fall 2019 Dateline Newsletter “The Risks of EHR Software Changes and Updates.” Don’t let the technical nature of the EHR discussions lull you into complacency. Physicians should know that EVERYTHING they do within an electronic medical record is discoverable… including when they access records (is it right after you were served notice of a pending lawsuit against you?), update records, delete records (including a record of WHAT was deleted and WHEN information was deleted – which will ALWAYS RAISE A RED FLAG), whether the ‘clip and paste’ function was used to complete records, etc…. Please take a moment to review the MLMIC article and reflect on how you address electronic health record documentation in your practice.

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