FP Report -- April 1999
FPs in Medicare: Overwhelmed by red tape
Family physicians participating in Medicare are overwhelmed by red tape.
AAFP Board Chair Neil Brooks, M.D., of Rockville, Conn., took that message to Medicare's Practicing Physicians Advisory Council March 15 in Washington, D.C.
"Whether it is physician office laboratories, coding, reimbursement or even death, the Health Care Financing Administration probably has issued a rule about it," said Brooks. "The rules and paperwork have erected a very real and daunting challenge to simply treating the beneficiary."
HCFA's new Physician Regulatory Initiative Team is trying to identify the most burdensome Medicare rules. To help the team, 80 AAFP commission and committee members filled out a survey on Medicare hassles in January.
Brooks summarized what the survey respondents said:
- Medicare is the only program that continually brands physicians as guilty of fraud and abuse and creates a climate of fear of civil or criminal sanctions for honest mistakes. Doctors are surrounded by an "aura of criminality," as one respondent put it.
- Medicare is increasingly inflexible. Physicians feel they are losing control of medical decision making.
- Contradictory answers and delays by Medicare carriers make it hard to comply with regulations. Physicians fear that even asking for explanations of rules may lead to audits.
- Survey respondents most often named the following as problems: medical necessity rules, rules about use of notes written by students in teaching situations, and documentation of evaluation and management services.
Brooks suggested ways to alleviate the hassles and asked the advisory council to recommend those changes to HCFA. Brooks' testimony is at www.aafp.org/x1191.xml.
FP Report is published by the AAFP News Department. Copyright © 1999 by American Academy of Family Physicians.
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