Reimbursement Subcommittee
Committee Roster
Chair
Steven L. Allen, MD
('28)
Appointed Members
Paul A. S. Fishkin, MD
('25)
Laahn H. Foster, MD
('26)
Ellen Fraint, MD
('26)
Jonathan Gerber, MD
('28)
Samantha M. Jaglowski, MBA, MD, MPH
('26)
Amar Harry Kelkar, MD, MPH
('25)
Taiga Nishihori, MD
('28)
Girindra Raval, MD
('27)
Bipin N. Savani, MD
('26)
Anand Tandra, MD
('28)
Kelly J. Walkovich, MD
('28)
Liaisons
Chancellor E. Donald, MD
('28)
-
Erin Jou, MD
('28)
-
Amar Harry Kelkar, MD, MPH
-
Amar Harry Kelkar, MD, MPH
-
Mary-Elizabeth M. Percival, MD
('25)
-
Jamile M. Shammo, MD
-
Staff Liaison
Carina Smith, MA
Committee Mandate
The Reimbursement Subcommittee (a subcommittee of the Committee on Practice) focuses on securing appropriate coverage and reimbursement for hematology services, including evaluation and management (E/M) services and hematology-focused procedures. The subcommittee also focuses on educational efforts for ASH members regarding coding and reimbursement. As part of this effort, the subcommittee monitors and provides feedback on the annual proposed rules impacting physician reimbursement in the United States, including the Inpatient Prospective Payment System; the Physician Fee Schedule; the Hospital Outpatient Prospective Payment System; and the Quality Payment Program. Additionally, the subcommittee works to identify discrepancies in coverage determinations and advocates for the appropriate coverage of services through local and national Medicare coverage decisions, and by supporting engagement with the Medicare Administrative Contractors at the annual ASH Carrier Advisory Committee (CAC) Network Meeting. The subcommittee also provides insight on legislation impacting physician reimbursement. The subcommittee advises the Committee on Practice on all coverage and reimbursement-related issues by formulating positions on pending federal legislation, regulatory, local Medicare coverage, and occasionally, private insurance developments. The subcommittee also works to identify other specialty professional organizations that may be interested in working with ASH on these issues.
The chair and members of the Reimbursement Subcommittee serve staggered four-year renewable terms (unless otherwise indicated). Members are expected to participate in scheduled virtual meetings as well as the Committee on Practice’s one-day winter virtual meeting and attend the annual ASH CAC Network Meeting. Subcommittee members review new hematology-specific Current Procedural Technology (CPT) code requests from the American Medical Association (AMA) and requests from the Relative Value Scale Update Committee (RUC) of the AMA.
Given the strategic activities of the Reimbursement Subcommittee, members of the subcommittee are prohibited from simultaneously serving in leadership positions on government affairs; reimbursement, regulatory, and practice policy; or advocacy committees of other medical organization or any other organization that has significant overlap with ASH interests. Any relationship, including leadership positions, must be disclosed formally as a conflict of interest.
The Reimbursement Subcommittee structure includes the following liaison positions:
· ASH Representative and Alternate Representative to AMA RUC
· Advisor and Alternate Advisor to AMA CPT Advisory Committee
· Representative to American College of Physicians (ACP) Subspecialty Advisory Group on Socioeconomic Affairs (SAGSA)
The chair of the Reimbursement Subcommittee serves as a liaison member of the Committee on Practice and is expected to attend the meetings of that committee.
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