AMGA Urges CMS to Address Provider Concerns in Good Faith Estimate Process

Alexandria, VA – AMGA today raised concerns about the good faith estimate (GFE) process and how it is creating an administrative burden for medical groups. In a letter to the Centers for Medicare & Medicaid Services (CMS) on the GFE process, AMGA highlighted problems with the requirements, which have resulted in significant challenges for providers to effectively schedule, coordinate, and deliver care. AMGA members have raised concerns in three key areas: confusing and conflicting guidance, staffing constraints, and the cost and lack of infrastructure to complete GFEs. AMGA members report completing more than 45,000 GFEs in a month and expect that number will increase. AMGA recommends that CMS work with stakeholders to develop a process in which GFEs are beneficial for patients, while not causing additional administrative burdens to providers. 

“The current GFE requirements impose additional stress to an already strained healthcare workforce,” said AMGA President and CEO Jerry Penso, M.D., M.B.A. “CMS should reform the process so that the estimates provide the information patients need, without creating new administrative obstacles for providers to overcome.”

AMGA’s comments expand on earlier comments on the Requirements Related to Surprise Billing; Part II (86 FR 55980) of the Interim Final Rule (IFR) issued by the Departments of Health and Human Services (HHS), Treasury, and Labor, and the Office of Personnel Management. AMGA supports the spirit of the transparency provisions in the No Surprises Act (NSA) and asks CMS, HHS, and other Departments to implement critical patient protections. Member groups of AMGA appreciate the value of developing a culture of transparency to empower patients to make informed decisions about their health care.

The letter is available here.

###

About AMGA
 AMGA is a trade association leading the transformation of health care in America. Representing multispecialty medical groups and integrated systems of care, we advocate, educate, innovate, and empower our members to deliver the next level of high performance health. AMGA is the national voice promoting awareness of our members’ recognized excellence in the delivery of coordinated, high-quality, high-value care. More than 175,000 physicians practice in our member organizations, delivering care to one in three Americans.