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Coding and Payment Policy Subcommittee

Reports to:

Medical Practice and Quality Committee

Charge

Advise the Medical Practice and Quality Committee on: (a) Medicare and other third-party payer policies to improve coverage, improve payment tied to quality, value, and shared savings through alternative payment models, and reduce practice hassles; (b) recommendations to other major entities that interface with Medicare and other third-party payers; (c) recommendations for improving coding and documentation of physician services; resources to help internists practice high-quality, cost-effective care; content for annual Internal Medicine meetings regarding Medicare and other third-party payers; d) recommendations based on the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015 (MACRA) and other relevant payment reform laws that support the ongoing transformation of healthcare delivery by new Medicare payment and delivery models for physicians and other clinicians.Assist ACP's CPT advisor in reviewing proposed coding issues and policies from the CPT Editorial Panel and develop CPT and other coding proposals that advance the needs of internists, and function as a ACP's Specialty RVS Committee, as required by the RUC's guidelines for specialty societies.

Composition (10)

Chair; 9 members to include Chair, Subspecialty Advisory Group on Socioeconomic Affairs (SAGSA); any ACP member serving on the Current Procedural Terminology (CPT) Editorial Panel and alternate; CPT advisor, or American Hospital Association Coding Advisory Board; and the RUC representative or alternate and RUC advisor and alternate. Non reserved slots should go to individuals identified as possessing expertise in coding, reimbursement, payer policy, alternative payment models, current or past Medicare or private payer Medical Director, or Medicare Carrier Advisory Committee (CAC) member preferred.

Terms

One-year, renewable up to three times for a total of four years, unless additional time is approved by the Chair, BOR.

2016-17 Members

Michael (Doug) Leahy, MD, MACP, Chair
Summit Medical Group
Powell, TN
Specialty: IM

James F. Bush, MD, FACP
State Medicaid Med Officer
Office of Health Care Financing
Cheyenne, WY
Specialty:  IM

Yul D. Ejnes, MD, MACP
N. Scituate, RI
Specialty: IM

Jeannine Z. Engel, MD, FACP
Associate Professor of Medicine
Nashville, TN
Specialty: IM

William E. Fox, MD, FACP
Charlottesville, VA
Specialty: IM

Tiffany Groover, MD
Laurel, MD
Specialty:  Internal Medicine

Scott Manaker, MD, PhD, FACP
Hospital of the University of PA
Philadelphia, PA
Specialty: PUD, Critical Care

Mary M. Newman, MD, MACP
Lutherville, MD
Specialty:  Internal Medicine

Louis S. Snitkoff, MD, FACP
(Governor)  New York Hudson Valley
Chief  Medical Officer
CapitalCare Medical Group
Albany, NY
Specialty:  IM

Donna E. Sweet, MD, MACP
University of Kansas
Internal Medicine Midtown
Wichita, KS
Specialty: ID

Staff Liaison: Shari Erickson SErickson@acponline.org