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Fam Pract Manag. 1999;6(4):17

Anti-fraud campaign hits the streets

In an effort to enlist senior citizens in the fight against Medicare fraud, the Department of Health and Human Services (HHS), the Department of Justice and the American Association of Retired Persons have launched the “Who Pays? You Pay” campaign. Seniors are being urged at training sessions nationwide to report questionable charges on their health care bills through a toll-free hot line maintained by the HHS Office of Inspector General.

The government is offering up to $1,000 to those who provide information leading to the recovery of fraudulent Medicare payments. In addition, under the False Claims Act, individuals can file suit against providers who defraud Medicare and may be eligible to receive up to 30 percent of the money recovered.

In the Feb. 24 Wall Street Journal, AMA President Nancy W. Dickey, MD, said the campaign “drives a wedge between patient and physician.” The AMA is urging the government to focus on documented, intentional acts of fraud and to simplify its more than 100,000 pages of Medicare rules and regulations.

The AAFP is advising family physicians and their staffs to be prepared to respond to an increased number of billing inquiries politely, promptly and thoroughly. Practices can give patients an alternate number to call — HCFA's Medicare Answers hot line (800-444-4606), which gives beneficiaries basic information about how Medicare works. Its operators can direct patients to other sources for explanations of their Medicare statements.

Y2K Update: Health care worst prepared, says Senate report

Health care is the industry most unprepared for potential year 2000 computer problems, says a report released last month by the Senate Special Committee on the Year 2000 Technology Problem. The report estimates that more than 90 percent of doctors' offices have yet to address the millennium bug and says that, as of last October, 64 percent of hospitals had no plans to test their Y2K fixes.

According to the report, noncompliant software could make patient data and electronic billing inaccurate, and it could interfere with research, manufacturing and distribution of drugs. Embedded microprocessors, found in biomedical devices as well as more common equipment like elevators and heating systems, could malfunction. The report also cautions that, because of the interconnectedness of information systems, even a compliant computer system could become corrupted simply by communicating with a noncompliant system.

“I don't believe the health care industry's lack of preparedness will necessarily mean loss of life, but it could seriously impact care,” said committee chair Robert F. Bennett (R-Utah). He added that “Medicare, the backbone of our nation's health care payment system, is in serious trouble.”

GAO says HCFA isn't ready after all

A recent General Accounting Office (GAO) report says HCFA's Y2K readiness has been “considerably overstated” and contends that 54 computer systems said to be ready for 2000 are not. The GAO cautions that there may not be enough time left for complete testing and is encouraging HCFA to develop backup plans.

Responding in the Feb. 25 Washington Post, HCFA Administrator Nancy-Ann Min DeParle said HCFA's systems have been tested and that a second round of testing will be completed by October. She said hospitals and doctors will receive their Medicare payments on time in January.

Match numbers drop again for family practice

The fill rate for family practice residency programs dropped to 82.6 percent this year, compared with 85.5 percent in 1998 and 89.1 percent in 1997, according to preliminary information from the National Resident Matching Program. Of 3,265 positions offered in 1999, 2,697 were filled; last year, 2,814 of 3,293 positions were filled.

This is the second consecutive year that match numbers for family practice have been down. But AAFP President Lanny Copeland, MD, believes the drop will be short-lived because Academy membership is significantly higher among current third-year medical students than current fourth-year students. “There is reason to believe that more of next year's fourth-year students will pursue family medicine,” he says.

“Students have been inundated with media reports predicting the end of managed care,” Copeland says, and a lessened demand for primary care physicians. But he says such reports are false: “There continues to be a need for well-trained, high-quality family physicians.”

Physicians targeted for unionization drive

A new affiliate of the Service Employees International Union has announced it will spend $1 million to organize the nation's salaried physicians and will begin its campaign in union-friendly California, Florida, Washington state and Washington, D.C. The new 15,000-member National Doctors Alliance is the result of the consolidation of the Committee of Interns and Residents, the Doctors Council and the United Salaried Physicians and Dentists.

An estimated 6 percent of the nation's 680,000 physicians already belong to unions, the March 2 Boston Globe reports, but about half of American physicians are prohibited from bargaining collectively because they're considered independent contractors.

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Copyright © 1999 by the American Academy of Family Physicians.

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