Family physicians who have documentation of appropriate training and current clinical competence are qualified to administer nerve conduction studies and should be paid by Medicare to do so, said AAFP Board Chair Mary Frank, M.D., of Mill Valley, Calif., in a letter to Robert Kamps, M.D., medical director of Palmetto GBA in Columbus, Ohio.
Academy Backs Ohio AFP on Scope of Practice Issue
By News Staff
6/23/2006
Palmetto GBA is a subsidiary of BlueCross BlueShield of South Carolina and a Medicare carrier in Ohio and other states.
The intent of the May 26 letter was to support the Ohio AFP in asking the carrier not to implement its proposal to summarily exclude local Medicare coverage of nerve conduction studies and other neuromuscular diagnostic procedures performed by family physicians. To do so would be detrimental to FPs and their patients, said the AAFP.
The Ohio AFP submitted its own comment letter to Kamps on May 23.
Frank noted in her letter that Palmetto's proposal states that neuromuscular electrodiagnostic, or EDx, studies must be performed by qualified physicians or physiatrists who have successfully completed a physical medicine or neurology residency or fellowship program accredited by the Accreditation Council for Graduate Medical Education. Completion of such a program, Palmetto's letter says, qualifies the physician to sit for either of two examinations that Palmetto would recognize as appropriate certification to conduct EDx studies -- the American Board of Electrodiagnostic Medicine Examination and the American Board of Physiatry and Neurology's Added Qualifications in Clinical Neurophysiology Examination.
"We are not aware of any evidence that would support such a limitation," said Frank, adding that FPs are well trained and fully capable of performing standard office-based diagnostic procedures. For procedures such as nerve conduction studies, the letter states, "if a family physician has documentation of training and current clinical competence, he or she should be credentialed and paid to perform the procedure, and Medicare should not deny coverage simply on the basis of the physician's specialty or specified board certification."
"Family physicians are career-long learners who continuously update themselves on advances and developments in medicine and avail themselves of the opportunity to learn procedures such as electrodiagnostic studies to enhance their ability to provide comprehensive care to their patients," said Frank.
"Requiring Medicare patients to see a neurologist or a physiatrist rather than their family physician for these tests does nothing to improve health care quality," she said. Frank added that the proposal "unfairly restricts" family physicians' ability to effectively diagnose and treat their Medicare patients and makes it more difficult and inconvenient for patients to access needed medical care.
Frank echoed the Ohio AFP's recommendation to Palmetto to allow FPs to continue to deliver the patient care for which they have been trained. Either delete the qualifications section of the proposal or revise it to allow Medicare coverage of neuromuscular diagnostic studies conducted by any qualified physician, said Frank.
The intent of the May 26 letter was to support the Ohio AFP in asking the carrier not to implement its proposal to summarily exclude local Medicare coverage of nerve conduction studies and other neuromuscular diagnostic procedures performed by family physicians. To do so would be detrimental to FPs and their patients, said the AAFP.
The Ohio AFP submitted its own comment letter to Kamps on May 23.
Frank noted in her letter that Palmetto's proposal states that neuromuscular electrodiagnostic, or EDx, studies must be performed by qualified physicians or physiatrists who have successfully completed a physical medicine or neurology residency or fellowship program accredited by the Accreditation Council for Graduate Medical Education. Completion of such a program, Palmetto's letter says, qualifies the physician to sit for either of two examinations that Palmetto would recognize as appropriate certification to conduct EDx studies -- the American Board of Electrodiagnostic Medicine Examination and the American Board of Physiatry and Neurology's Added Qualifications in Clinical Neurophysiology Examination.
"We are not aware of any evidence that would support such a limitation," said Frank, adding that FPs are well trained and fully capable of performing standard office-based diagnostic procedures. For procedures such as nerve conduction studies, the letter states, "if a family physician has documentation of training and current clinical competence, he or she should be credentialed and paid to perform the procedure, and Medicare should not deny coverage simply on the basis of the physician's specialty or specified board certification."
"Family physicians are career-long learners who continuously update themselves on advances and developments in medicine and avail themselves of the opportunity to learn procedures such as electrodiagnostic studies to enhance their ability to provide comprehensive care to their patients," said Frank.
"Requiring Medicare patients to see a neurologist or a physiatrist rather than their family physician for these tests does nothing to improve health care quality," she said. Frank added that the proposal "unfairly restricts" family physicians' ability to effectively diagnose and treat their Medicare patients and makes it more difficult and inconvenient for patients to access needed medical care.
Frank echoed the Ohio AFP's recommendation to Palmetto to allow FPs to continue to deliver the patient care for which they have been trained. Either delete the qualifications section of the proposal or revise it to allow Medicare coverage of neuromuscular diagnostic studies conducted by any qualified physician, said Frank.
