ACA President Completes Term as Co-Chairman of AMA HCPAC Review Board

Author: Nicole Racadag, MSJ/Friday, January 08, 2016/Categories: August 2015

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By Nicole Racadag

IN APRIL 2011, ACA PRESIDENT ANTHONY W. HAMM, DC, FACO, MADE HISTORY as the first chiropractic physician to be elected to serve as co-chair of the American Medical Association’s (AMA)/Specialty Society Relative Value Scale Update Committee (RUC) Health Care Professionals Advisory Committee Review Board (HCPAC). In this capacity he also served on the AMA RUC. the RUC makes annual recommendations regarding new and revised CPT® services, as well as potentially misvalued services of the Resource-Based Relative Value Scale (RBRVS) to the Centers for Medicare and Medicaid Services (CMS), which determines Medicare provider payment.

Dr. Hamm previously served as the chiropractic advisor to the AMA RUC/HCPAC beginning in 2002. In April 2013, he was re-elected for a second term as the RUC HCPAC co-chair and served in that role until his term ended in April 2015.

As the first chiropractic physician to serve as HCPAC cochair, how did you help chiropractic have a voice in the national health care discussion?

Actually, chiropractic has had a voice on the HCPAC since the mid-1990s. In August 1995, Jerilynn Kaibel, DC, was appointed as ACA’s RUC HCPAC advisor and Craig Little, DC, was appointed as AMA CPT HCPAC advisor. They have the distinction as being the first doctors of chiropractic appointed to AMA advisory committees.

As the elected HCPAC co-chair, my duties included assisting with agenda development, presiding over the three HCPAC meetings each year and representing the HCPAC on the AMA RUC panel. The HCPAC is charged with developing recommendations on values for the non-MD/DO-related CPT codes.

How did your background in reimbursement issues prepare you for your role with AMA RUC?

I would say that my experience in health care reimbursement issues, including CPT® coding and the RBRVS system, prepared me for my role with the AMA RUC. In my role as HCPAC advisor, I developed experience in reviewing and contributing to appropriate recommendations for CPT® code values across specialties. I’ve had the opportunity to teach coding, documentation, Medicare and risk management to the chiropractic profession for the past several years and contributed as an author to ACA’s Chiropractic Coding and Compliance Manual.

How did your AMA RUC experience affect your leadership role at ACA?

I would say it was vice versa. My role at ACA actually helped me be a more effective leader of the HCPAC. Clearly my role as president of ACA is much broader than my role as co-chair of HCPAC.

Not unlike ACA, the RUC and RUC HCPAC are represented by dedicated physicians and health care professionals who contribute their time, energy and expertise making both organizations successful.

Do you believe the chiropractic profession is valued more by the payers and the public now?

When we look at what we’ve seen in regard to the essential services we provide in the state health exchanges, including the Federal Employee Plan (FEP), which modified its benefit language last year to account for the provisions of Section 2706(a), I think the public actually has placed a greater value on the services delivered by chiropractic physicians. CMS is unfortunately still lagging behind, but with the advent of value-based payment models, our profession is poised to make a much larger contribution to population health.

Any final takeaways from your last AMA RUC meeting, as co-chair, in Chicago?

During my final meeting as co-chair in April, I enjoyed a very warm send-off from my colleagues from both the HCPAC and the RUC panel. I publicly thank my alternate and ACA’s research consultant, Christine Goertz, DC, PhD, for her efforts in helping RUC HCPAC to understand the high-quality physician-level care that chiropractic physicians provide their patients. I also thank Meghann Dugan-Haas, ACA’s director of federal and regulatory affairs, for her staff support during my tenure as co-chair. Finally, it has been a privilege to participate and represent my HCPAC colleagues on the full AMA RUC. As a result of this participation and leadership role, I firmly believe the chiropractic profession will be better represented in this vital resource-based relative value system going forward.

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