Part B Insider (Multispecialty) Coding Alert

Published on Sat Jul 22, 2006 PDF

Your payments have been frozen since 2001, Senators note

If Congress doesn't get its act together, you could face another 5- percent cut to your overall Medicare reimbursement next year, warns a new letter from Sens. Jon Kyl (R-AZ) and Deborah Stabenow (D-MI).

And payments are set to shrink by 37 percent by 2015, according to the letter to Senate leaders Bill Frist (R-TN) and Harry Reid (D-NV). -The average 2006 Medicare rates for physicians are about the same as they were in 2001,- says the letter, signed by 80 Senators. If the cuts go through, payments will have fallen about 20 percent behind inflation for medical practice costs.

The Senators point to predictions that there could be a shortage of 85,000 physicians by 2020. They also cite an American Medical Association survey showing 47 percent of physicians will decrease their numbers of new Medicare patients if next year's cuts go through. -To preserve Medicare beneficiaries- access to care, we must act soon to avert these cuts to physician payments,- they write.

In other news:

- You can throw away your stereotypes about the sort of people who visit the Emergency Department most often, according to a new survey. The communities with the highest rates of ED use aren't those with the most uninsured people, Hispanics or non-citizens.

Rather, areas with a lot of elderly people and communities where people have to wait a long time for appointments with their own doctors send people to the ED most often, according to USA Today. Also, areas where a small proportion of the population belongs to an HMO have a higher rate of ED use.

- Downers Grove, IL psychiatrist Naseem Chaudhry allegedly billed for more than 24 hours worth of services in one day, prosecutors allege. He also allegedly admitted patients to a facility where he worked as medical director to claim Medicare reimbursement, when there was no medical necessity. Chaudhry faces 14 counts of health care fraud, according to the Chicago Tribune.

- More and more physicians are going house-call only, which means they don't have to have an office, according to an article in the Naples, FL News. The May issue of the Journal of the American Medical Association said that house calls to Medicare beneficiaries rose 40 percent since 1998, when Medicare boosted house-call payments. There are now 16 physicians in Florida who only do house calls, saving on the expense of nurses and office space.