GAO calls data used to determine physician pay potentially flawed

Federal investigators say the current process to review and recommend how Medicare pays doctors leaves it susceptible to inaccurate reporting and conflicts of interests.

report (PDF) released Thursday by the Government Accountability Office found “weaknesses” in the survey data used by the American Medical Association/Specialty Society Relative Value Scale Update Committee, also known as RUC.

Investigators said the committee's recommendation process “relies on the input of physicians who may have potential conflicts of interest with respect to the outcomes of CMS's process.” 

In terms of the data, which is compiled by annually surveying physicians to provide updates on existing procedures and to introduce new ones, the report found the RUC survey's response rate was low. For 2015, the median number of responses to the 231 surveys conducted was 52 for a rate of 2.2%, with less than 30 respondents for 23 surveys.

“Given the process and data-related weaknesses associated with the RUC's recommendations, such heavy reliance on the RUC could result in inaccurate Medicare payment rates,” the report concluded.