APMA News - January/February 2023 - 27

2023 Reimbursement Issues in
Focus at CAC-PIAC Meeting
The 22nd Annual Joint National Carrier Advisory
Committee (CAC) and Private Insurance Advisory
Committee (PIAC) Meeting took place on Friday,
November 11, 2022, in Arlington, VA. CAC and
PIAC representatives are your front-line defense
for Medicare and private insurance reimbursement
issues. These individuals work directly with
carrier medical directors and others to address
major concerns. For information about the CACPIAC
program, including a list of representatives,
visit www.apma.org/cacpiac.
During the meeting, representatives heard a
variety of valuable updates from industry experts.
Cindy Moon, MPP, MPH, vice president at Hart
Health Strategies and APMA Health Policy and
Practice consultant, offered attendees an update
on the 2023 Medicare Physician Fee Schedule
and the potential impact on podiatrists. The initial
analysis was not encouraging, but APMA immediately
went to work to advocate for its members.
Due to the efforts of APMA and numerous other
specialties and stakeholders, the 2023 Omnibus
Appropriations bill passed and signed into law in
December 2022 contained Section 4112, which
provides additional support for physicians and
other health-care professionals in adjusting to
Medicare payment changes. While this additional
support does not avert the full anticipated
4.5-percent cut, it provides some relief against
the cost pressures facing podiatric physicians and
other health-care providers. Moon also discussed
telehealth, the roadmap to the end of the public
health emergency, and LCD/LCA concerns.
APMA Coding Consultant Jeffrey Lehrman, DPM,
provided an update on MIPS participation and
coding changes in 2023, including significant
changes to E/M coding. For more information,
visit www.apma.org/em.
Kelli Back, Esq., addressed private insurance
trends and concerns, with a particular focus
on Medicare Advantage plans and the ongoing
issue with onerous record requests and frequent
denials. Back also touched on the Provider NonDiscrimination
clause and No Surprises Act, and
their impact on physicians.
Two standout representatives received special
recognition during the event. Franklin Kase, DPM,
was recognized with a Distinguished Service
Award. Dr. Kase is a PIAC representative from
California whose dedication and commitment to
podiatry during his decades-long service to the
profession cannot be underestimated. He has
been pivotal in some significant advocacy victories,
including an extended battle with Anthem over the
denial of E/M claims with modifier 25. Dr. Kase was
unable to attend the meeting, but CPMA Executive
Director Jon Hultman, DPM, accepted the award
on his behalf.
Additionally, Mark Block, DPM, was presented
with the 2022 CAC & PIAC Representative of the
Year award. Dr. Block has long represented Florida
and the profession as a whole and has a track
record as an exemplary representative who has
cultivated a productive, mutually beneficial relationship
with his carrier medical director. Dr. Block
has also served in numerous leadership positions at
APMA and the Florida Podiatric Medical Association
over the years.
An invaluable aspect of any CAC-PIAC meeting
is collaboration between the representatives, and
this year's meeting was no different. However, as a
novel approach to these breakout sessions, APMA
brought in facilitator Lowell Aplebaum to lead the
discussion. Earlier in 2022, Aplebaum led the APMA
Board of Trustees and senior staff through strategic
planning. With Aplebaum's focused direction, the
attendees were able to identify key areas of focus
for the upcoming year. Also during the meeting,
attendees learned about a new online community
tool representatives will use for better collaboration,
APMA Communities. This exciting site will initially
serve as an online forum for select committees and
work groups but will expand to all association members
with common interests in the future.
Expect to hear more about the outcomes
throughout the year from your local CAC-PIAC
representatives. For more information about the
CAC-PIAC process, and to find out who represents
you, visit www.apma.org/cacpiac. For additional
questions, contact healthpolicy.hpp@apma.org..
APMA.ORG
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http://www.apma.org/cacpiac http://www.apma.org/em http://www.apma.org/cacpiac http://www.APMA.ORG
APMA News - January/February 2023

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