Action Alert: Patients Over Paperwork


The Center for Medicare and Medicaid Services (CMS) is asking for feedbackon solutions for “Reducing Administrative Burden to Put Patients Over Paperwork.”

AAPS will be submitting ideas to CMS, but your help is needed to help make the most of this opportunity.

Here’s how you can help:

1) Copy the below template comments.

Secretary Azar and Administrator Verma,

The following comments are in response to the CMS Request for Information (RFI) CMS-6082-NC. Thank you for the opportunity to submit solutions for putting patients over paperwork.

Here are five targeted policy changes CMS should strongly consider as it seeks ways to reduce unnecessary administrative burdens:

1) End penalties for refusing to subject patient safety and privacy to federally approved EHRs designed for the benefit of bean counters and bureaucrats instead of for patients. In addition, CMS should exercise maximum authority under law to exempt physicians, and their patients, from all MACRA and MIPS requirements that detract from patient care, like policies that reward physicians for providing less care, or that encourage use of “quality” metrics devised for DC, not patients.

2) Revoke obsolete rules in 42 CFR §405.415 that require private contracts between Medicare patients and physicians opted-out of Medicare be renewed every two years. This regulation is no longer authorized by statute and is an unnecessary burden on both patients and physicians.

3) Address Medicaid rules harming patients’ access to independent physicians. Misguided rules stemming from ACA Section 6401(b)(1) and the Cures Act Section 5005(b)(2) require physicians ordering and prescribing for Medicaid patients, or treating Medicaid Managed Care patients, to enroll in Medicaid, even when the physicians receive no payment directly from the Medicaid program. Such administrative burdens result in reduced patient choice and increased costs to taxpayers. CMS should use all available discretion to halt enforcement of these regulations while it works with Congress to end them.

4)  Delay “Appropriate Use Criteria” (AUC) red tape that discourages and delays needed diagnostic testing for Medicare patients. CMS should put the brakes on pending implementation of the “Appropriate Use Criteria Program.” Requiring physicians to consult a federally overseen “Clinical Decision Support” algorithm when choosing care for Medicare patients not only creates more paperwork burden, but is an improper intrusion into the patient-physician relationship.

5) Protect patient choice by enforcing existing CMS regulations that limit counter-productive certification mandates on physicians. An under-reported source of administrative burden, that puts paperwork over patients, are the Maintenance of Certification requirements imposed by specialty certification boards, in collusion with hospitals and insurers. This anti-competitive behavior is blocking patient access to physicians of their choice and driving up costs for patients and taxpayers without any proven benefit. Nationwide these costs have been estimated to be $5.7 billion over 10 years and 32.7 million hours lost on compliance that could be spent on patient care. CMS should enforce a longstanding, but currently disregarded, “Condition for Participation” outlined at 42 CFR 482.12(a)(7), that constrains the imposition of these requirements at Medicare participating hospitals.

Thank you for considering the above requests that, when implemented, will prioritize patients over paperwork. 

2) After copying the above comments, visit the comment portal and paste them in to the submission box. You can then modify the comments as desired before submitting them.

The comment portal is available at:

Comments are due by 5:00pm Eastern on August 12, 2019