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AAFP Board Chair Spotlights Breadth of Family Medicine Training in Letters to CMS
FPs Well-qualified to Diagnose, Treat Mental Health Problems; Counsel About Alcohol Misuse
By News Staff
Heim pointed out that in its proposal, CMS made a number of references to primary care physicians referring patients to mental health clinicians, "as if primary care physicians are not performing as mental health providers themselves."
- In a recent letter to CMS, the Academy voiced support for Medicare coverage for annual screenings for depression.
- The Academy pointed out that family physicians screen, diagnose and treat patients with mental health disorders.
- The majority of patients with mental health issues access the health care system through primary care physicians.
- The AAFP also supports CMS' proposed annual alcohol screenings and its proposed retraction of certain Medicare signature requirements.
Moreover, said Heim, "The desire of patients to receive treatment from their primary care physicians, or at least to have their primary care physicians more involved in their care, has been repeatedly documented."
AAFP Hails CMS' Retraction of Medicare Signature Requirements
CMS adopted the signature requirements as part of the final 2011 Medicare physician fee schedule. The rule required the signature of a physician or a qualified nonphysician signature on "requisitions," as opposed to orders, for clinical diagnosis laboratory tests. CMS recently proposed another rule that would retract that requirement.
Last year, the Academy opposed implementation of the signature policy (38-page PDF; About PDFs), arguing that it would create "an excessive burden" for physicians. In her recent letter to Berwick on the topic, Heim said, "Through publication of this proposed rule, CMS is taking the first of, hopefully, many steps that acknowledge the need to modify or repeal burdensome regulations."
"Specifically, we support the proposal for annual alcohol screenings and, for (patients who) screen positive, up to four brief, face-to-face behavioral counseling interventions per year for Medicare beneficiaries, including pregnant women," said Heim.
As outlined by CMS, counseling interventions would be appropriate for patients who
- misuse alcohol but who do not meet the criteria for alcohol dependence and
- display competence and alertness at the time counseling is provided.
According to Heim, despite the fact that family physicians would face challenges in integrating the recommended interventions -- two 10- to 15-minute office visits -- into already busy daily practice schedules, they remain the clinicians best positioned to screen for alcohol use disorders.