April 2002 • Volume 8 • Number 4 |
You can testify, too
Patients ensnared in web of regulations, physicians tell
HHS
Patients suffer when doctors and hospitals are flooded with excessive paperwork and Medicare and Medicaid audits. So said FP Jesus Llanes, M.D., of Miami during the Feb. 25 - 26 hearing in Miami of the HHS Advisory Committee on Regulatory Reform.
You, too, can testify before the committee -- or in writing -- about invasive HHS regulations. Get help with information from the Academy (see details at end of story). But first, here's what some physicians discussed at the panel's first regional hearing.
Llanes, who cares for an underserved population, said his practice is filled with patients with HIV and AIDS. Recently, he was investigated for alleged overcharges. Llanes answered the Medicare carrier's allegations with many patient records, most of which were never even opened by the investigator, he said.
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"Patients are dying because of what the
government is doing." |
The case advanced to a hearing, but Llanes said the process led him to believe he was "guilty until proven innocent." He closed his practice during the year it took him to prove his innocence. "Over 20 of my patients with AIDS -- who didn't have to -- died within eight months," Llanes told the HHS panel.
"Patients are dying," he said, "because of what the government is doing. It's costing practices, and -- worst of all -- it's costing lives."
In another case, a recent "strange application" of Emergency Medical Treatment and Labor Act regulations nearly ended the life of a 15-year-old patient with hydrocephalus, testified Michael Dennis, M.D., a Washington, D.C., neurosurgeon.
Dennis had operated on the child at birth to implant a shunt. The girl was uninsured and living in West Virginia when she was taken to an ER with a shunt obstruction and became comatose.
The ER staff called Dennis and said they were transporting the patient to him in Washington -- a four-hour drive away. He urged them to transport the girl to the closest hospital with a neurosurgeon on call so she would get immediate care. The hospital staff refused and told Dennis that if he didn't accept the patient, he would be guilty of an EMTALA violation.
"He (the ambulance driver) passed 13 hospitals with that little girl, and I saved her life," Dennis said. "There's no statement (within EMTALA), no reference to the closest hospital that can provide services anywhere, and I think that is one of the big missing links."
MICROMANAGING MEDICINE
EMTALA has many unfunded mandates and on-call responsibilities for which physicians won't get paid, said FP G. Kristin Crosby, M.D., of Bellingham, Wash., who serves on the HHS advisory committee. "There's a lot of stupid stuff in those regulations that we need to change."
This committee, she said, is looking for a mechanism HHS can use to change the regulatory system. "If HHS is going to micromanage the practice of medicine, it must stay current," she said.
HHS committee chair Douglas Wood, M.D., told speakers at the hearing, "You bring valuable experience to this table. Each of you, from your different backgrounds, brings something else to this process."
That process, Wood said, stems from HHS Secretary Tommy Thompson's intention to find "concrete, tangible solutions and recommendations on ways that we can make the rules and regulations less onerous, less burdensome, to providers and beneficiaries across this country."
GET IN ON THE ACTION
Visit http://www.aafp.org/fedgov/x2451.xml to download AAFP testimony, talking points and a fact sheet that can help you prepare for a panel hearing. Talking points on topics of particular interest to the Academy include HIPAA, Advance Beneficiary Notices, graduate medical education and home health. Also on the site are hyperlinks to the HHS advisory committee's site, where you will find meeting locations, times and complete agendas as they become available. Written testimony on any of the topics should be faxed to Wood at (202) 401-7321.
At press time, the committee's second regional hearing, planned for March 20 - 21 in Phoenix, was to include discussion about Medicare+Choice and ABNs.
On the agenda at future meetings:
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Copyright © 2002 by
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