Fam Pract Manag. 2002 Jan;9(1):52-53.
Transcription in the hospital
I’m part of a six-physician family practice. A group of radiologists reads our X-rays and uses the hospital dictation system. The hospital says it is going to begin charging us for the transcription of the radiologist’s interpretation. Can we be charged for that?
It depends on what kinds of agreements exist between your practice, the radiologists and the hospital. Begin by reviewing these agreements (if they exist) to find out who if anyone may have agreed to bear the expense of transcription.
Often, the family practice does bear the transcription expense in this type of arrangement. However, in these cases, the practice gets to select the transcription service and the radiologist does the over-read and dictation in the family practice office.
Free or discounted medications
In preparing for an audit by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the hospital system I work for decided we could no longer accept sample medications from drug reps since we couldn’t keep up with the paperwork and pharmacy standards. Now we have no samples – not even over-the-counter medications such as ibuprofen. Pharmaceutical reps used to bring us coupons for free samples to be filled at the pharmacy. Is there another way I can help my patients?
As you’ve discovered, JCAHO recently made the decision to discourage drug sampling. Some argue that sampling encourages the use of higher-priced, name-brand drugs as well as the use of drugs the physician would never have prescribed. On the other hand, samples can help a physician determine the efficacy of a medication before prescribing a full regimen, and they have long been a source of medication for patients who cannot afford their prescriptions.
Most of the major pharmaceutical manufacturers have programs that will provide free or discounted medications; however, they are not available to everyone. Patients must meet the program criteria, and physicians must complete the necessary forms, which are evaluated by the manufacturer. It’s more laborious to obtain free or discounted drugs through these programs than it is through the use of the sample coupons you described. However, coupon availability will diminish as more organizations such as yours restrict sampling and as the pharmaceutical companies place more emphasis on direct-to-consumer advertising.
For more information on drug-assistance programs for needy patients, visit the following Web sites:
RxAssist.org, which is sponsored by the Robert Wood Johnson Foundation, lists the application criteria of numerous programs and provides the forms needed to apply for free pharmaceuticals for qualified, uninsured patients.
NeedyMeds.com contains information on pharmaceutical-assistance programs accessible by manufacturer, drug name or drug category.
RxHope.com, supported by the Pharmaceutical Research and Manufacturers of America (PhRMA) contains a comprehensive listing of assistance programs you can apply to online.
Reimbursement for frequent home visits
I have several home-bound patients who are on Medicare. How frequently will Medicare reimburse me for routine home visits to these patients?
According to national Medicare policy, Medicare will pay for a home visit as long as it is “reasonable and necessary” for the diagnosis or treatment of an illness or injury, regardless of frequency. Likewise, the Medicare Carriers Manual and Coverage Issues Manual do not include any frequency limitations for this service. However, you may want to check your carrier’s local medical review policies, which are available online at www.lmrp.net.
* Denotes member of FP Assist, the AAFP’s online clearinghouse for consultants and attorneys.
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