Newsletter

Am Fam Physician. 1999 Mar 15;59(6):1375-1376.

New Medicare Fraud Campaign Is Launched by AARP

The American Association of Retired Persons (AARP), in cooperation with the federal government, kicked off a new campaign against Medicare fraud on February 24. With major programs scheduled in 30 cities around the country, the goal of the AARP is to educate over 20,000 of its members on how to fight Medicare fraud. The message tells seniors to follow these three steps: (1) Go to the physician/provider who billed you and ask for clarification; (2) contact the Medicare carrier; and (3) call the hotline for the Office of the Inspector General. Physicians can expect that some Medicare beneficiaries will begin questioning patient bills to try to detect fraud. The American Academy of Family Physicians (AAFP) has alerted family physicians to the campaign and asked that they and their billing staffs be prepared to respond to an upswing in the number of billing inquiries. The American Medical Association recently met with Health and Human Services Secretary Donna E. Shalala, voicing a strong objection to the campaign and expressing concern “that the high volume of false alarm calls to physicians' offices generated by this media extravaganza will be counterproductive.“ More details on the effort may be found at the AARP's Web site at http://www.aarp.org/medfraud [corrected].

Clinical Laboratory Relief Bill Is Introduced in Congress

Continuing his commitment to help physicians who are overburdened by the federal government's requirements for clinical laboratory testing, Rep. Bill Archer (R-Texas) has introduced legislation to address the problem. HR 528, the Clinical Laboratory Improvement Act Amendments of 1999, would exempt from onerous CLIA requirements a clinical laboratory in a physician's office, including an office of a group of physicians, that is directed by a physician and in which examinations and procedures are either performed by or supervised by a physician and are solely as an adjunct to other services provided by the physician's office. Laboratories would not be exempt from CLIA requirements when performing Papanicolaou smear analysis. The bill has been referred to the House Commerce Committee, but no hearings have yet been scheduled.

NCQA Releases HEDIS 2000 Draft Document

The National Committee for Quality Assurance (NCQA) has released for review the draft technical specifications for the Health Plan Employer Data and Information Set (HEDIS) 2000, the latest update to the performance measurement tool used by more than 90 percent of the nation's health plans. HEDIS is a set of standardized performance measures that allow employers and consumers to compare health plans in such areas as access to care, preventive health and member satisfaction. The five new measures added to the HEDIS 2000 draft address heart disease, asthma and chlamydia, and menopause counseling. The new measures are designed to help focus the health care community's efforts where they can do the most good—on illnesses or conditions for which effective treatments exist but may be underused. More information is available on the NCQA's Web site at http://www.ncqa.org. The final HEDIS 2000 technical specifications will be available in June 1999.

AHA Chairman Calls for a Renewed Commitment to Patients and Community

At the annual membership meeting of the American Hospital Association (AHA) in Washington, D.C., AHA Chairman Fred Brown called for hospitals to renew their commitment to the patients and communities they serve. Noting the public's eroding trust in hosptials, Brown stated that renewing the covenant begins “in our own backyard with other providers, insurers, our governments, community groups of all types and the patient. It's people who make the difference, not programs of the month or bureaucratic policies.” Brown pointed out that all aspects of community life have a stake in creating a healthier community—including public and private agencies, businesses, schools and places of worship. Brown is vice chairman of BJC Health System in St. Louis.

Family Physician Is Named Medical Editor of the Mayo Clinic Health Letter

Robert D. Sheeler, M.D., assistant professor of family practice in the Mayo Graduate School of Medicine, Rochester, Minn., was named medical editor of the Mayo Clinic Health Letter in November. Dr. Sheeler is the first family physician to hold this position. He had been the associate medical editor for one and one-half years. Dr. Sheeler has been on the staff of the Mayo Clinic for nine years and is a consultant and clinical practice chair in the Department of Family Medicine. A 1981 graduate of the University of California, San Diego, School of Medicine, La Jolla, he completed a family practice residency program at St. Joseph Mercy Hospital, Mason City, Iowa. He has been a member of the AAFP since 1984.

New Report Places Cost of Epilepsy at $12.5 Billion Annually

A new report released by the Epilepsy Foundation places the annual national cost of epilepsy at $12.5 billion. According to the organization, this is the first time the cost of epilepsy has been calculated in more than 20 years. The report points out that every year about 181,000 new cases of seizures and epilepsy occur. While about 2.3 million Americans have seizures and epilepsy, the report notes that only about 500,000 are receiving medical care that adequately controls their seizures. Information for “Epilepsy: Report to the Nation” was taken from more than 20 scientific studies conducted between 1978 and 1998. The full text of the report is available on the organization's Web site, news and publications section, at http://www.efa.org.


Copyright © 1999 by the American Academy of Family Physicians.
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