The AST is currently seeking members to serve on our new Reimbursement Task Force. This group will work to identify, evaluate, and advance coding, coverage, and payment policies that support patient access to high-quality transplant care and the financial sustainability of transplant professionals. Task force members will also support the AST’s future work with the American Medical Association (AMA) House of Delegates (HOD). We are looking for key opinion leaders among AST’s membership with a strong interest in transplant reimbursement and ideas for improving current models.
The AST Reimbursement Task Force’s responsibilities will include:
Analyzing and giving technical feedback on AST comments on the annual physician fee schedule, hospital outpatient rules, and other relevant physician payment rules.
Evaluating and determining the need for AST comments on CMS national coverage determinations (NCDs), Medicare Administrative Contractor (MAC) local coverage determinations (LCDs), Medicare coverage policies affecting transplant, and proposed legislation that would impact transplant physician reimbursement.
Tracking Medicaid payment and coverage issues that significantly affect the specialty, particularly pediatric or safety-net access where relevant.
- Identifying and recommending AST responses to any commercial payer issues including coverage, prior authorization, and payment or coding policies.
Identifying data needs to support reimbursement advocacy efforts and help determine the appropriate mechanisms (e.g., survey, claims data, clinical evidence) to collect this information.
Supporting the AST’s future inclusion in the American Medical Association (AMA) House of Delegates, Specialty and Service Society, Current Procedural Terminology (CPT) Advisory Committee, and Relative Value Scale (RVS) Update Committee (RUC) and participate as needed.
Identifing needs and monitoring other groups’ efforts for new & revised CPT codes; evaluate potentially misvalued codes; develop surveys/data; support CPT applications and RUC presentations
Working with AST staff to assess AMA resolutions twice a year and evaluate potential impact on AST members. Recommend strategy related to AST engagement on AMA resolutions including, but not limited to, engaging with AMA staff and other societies, coalition building, AST statements
Reporting to the Board of Directors on AMA Activities
Advising the AST Board of Directors on reimbursement advocacy requests from outside entities (e.g., new procedures, devices, diagnostics, drugs, AI) and working with them to develop coding guidance, FAQs, webinars, toolkits, and practice resources as needed.
Serving as a mechanism to identify recurring reimbursement problems reported by members.
We are seeking a diverse group of 12-15 AST and transplant community members who have a strong interest in transplant reimbursement with ideas for improving current models to populate the Reimbursement Task Force. If you or someone you know is interested in being a part of this work, please complete a brief form to share your interest and experience using the link below by October 19.
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