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Understanding MOC Requirements
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Internal Medicine Meeting 2019
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ACP publication showcases what internists need to know in
March 12, 2013
(Washington) An updated version of An
Internist's Practical Guide to Understanding Health System
Reform, including revisions that offer an up-to-the-minute
understanding of how the Affordable Care Act will roll out in the
years to come, has been released by the American College of
The guide focuses on how the act will affect physicians and
"We've published this since 2010, and the guide really helps
define the provisions of the law being implemented," said David L.
Bronson, MD, FACP, ACP's president. "This is a great source and it
is written with the internist customer in mind: How does this
The new version of the guide mainly reflects changes in the
Affordable Care Act that have taken place since the Supreme Court
handed down its ruling last June deeming the law constitutional.
The revised guide also takes into account the political opposition
the law has faced at the state level.
Specific revisions include:
Medicaid expansion. The original law relied on
a federally funded expansion of Medicaid in 2014 to extend health
coverage to millions of Americans, with the threatened loss of
existing Medicare funding if states refused to expand the
"The Supreme Court's ruling gave states the option to not expand
without the threat of losing Medicaid funding," Bronson said. "That
was a significant shift and change, and the guide was updated to
reflect that decision. States across the country are in the process
of deciding whether they will expand their Medicaid programs, and
we are keeping a close eye on that."
Health insurance exchanges. The law also
requires states to set up health insurance exchanges by 2014, which
would serve as open marketplaces for individuals and groups looking
for health coverage. If a state balks at setting up its own
exchange, the federal government will step in and set up one on the
"In December, states were required to declare whether their
exchanges would be state or federally operated," Dr. Bronson said.
Of all states and the District of Columbia, 24 have refused to set
up an exchange and will have theirs implemented by the federal
government, 19 have elected to run their own exchanges and six will
partner with the federal government. Two states remain
Cost of implementation. The Supreme Court
decision to make the Medicaid expansion optional has reduced the
cost of implementing the Affordable Care Act, and that reduced cost
is included in the report. According to the Congressional Budget
Office, the expansion of coverage as a result of the health law is
estimated to cost roughly $1.2 trillion over the next decade, down
$84 billion from the CBO's last estimate in March 2012.
Value-based payment modifier. The guide gives
an updated description of the Centers for Medicare and Medicaid
Services value-based payment modifier, which provides the
opportunity for financial incentives for physicians in practices of
100 or more eligible professionals who participate in the Physician
Quality Reporting System. "Practices that participate in PQRS, when
they meet certain criteria, will have the opportunity to receive a
positive (or negative) adjustment in their Medicare payments," Dr.
Bronson said. "It's telling folks that if you participate and you
do well, you're going to get a bump up in your payments."
Though the payment modifier will not be implemented until 2015,
Dr. Bronson said it's important for physicians to understand its
provisions now because the 2015 modifier will be based on
performance and PQRS participation in calendar year 2013.
Dr. Bronson said he urges all internists to review the guide so
they'll have a clear understanding of what is coming up. "We wanted
to give physicians one place to look for information so they can be
ahead of the game," he concluded.
About the American College of Physicians
The American College of Physicians is the largest
medical specialty organization and the second-largest physician
group in the United States. ACP members include 133,000 internal
medicine physicians (internists), related subspecialists, and
medical students. Internal medicine physicians are specialists who
apply scientific knowledge and clinical expertise to the diagnosis,
treatment, and compassionate care of adults across the spectrum
from health to complex illness. Follow ACP on Twitter and Facebook.
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