Part B Insider (Multispecialty) Coding Alert

Published on Fri Feb 03, 2006 PDF

Bill would require EHRs and performance-based funding for feds

You could be seeing wider use of electronic health records in your office soon, if a new bill is successful.
The House Committee on Government Reform recently started debating H.R. 4859, the "Federal Family Health Information Technology Act." Under the bill, insurers would provide all Federal Employees Health Benefit Plan participants--nearly 8 million federal workers--with EHRs beginning in 2008.

Insurers would collect participants' health care, prescription claims and related health services data. Providers and participants could contribute employee-related health information to the participant's file, ranging from claims and services to family health history and over-the-counter medication usage. Participants could easily manage their EHR information through a Web-based service.

In other news:

• Federal legislation allowing small businesses to band together across state lines into associations to buy health insurance should guarantee coverage for mammography, OB-Gyn services , cervical cancer screenings and other women's health services, the American College of Radiology says. The ACR is working with Senators to make sure S. 1955, which passed the Health, Education, Labor and Pensions Committee, includes coverage for these procedures.

• Fewer physicians are providing charity care to uninsured patients, even as the number of uninsured patients increases, according to a study by the Center for Studying Health System Change. In 2004-2005, 68 percent of doctors said they provided free or discounted care to uninsured patients, down from 76 percent 10 years earlier, according to an article in the March 23 Washington Post.

• The Centers for Medicare & Medicaid Services chose six sites for a demonstration project aimed at detecting cancer early and reducing the disparities in cancer care between minorities and other Americans. They include Johns Hopkins Medical Center in Baltimore, MD and Josephine Ford Cancer Center in the Detroit, MI area.

• CMS revised carrier complaint procedures in Transmittal 18, dated March 17, including complaints to your carrier and your CMS regional office.

• CMS' methodology for calculating the error rate through the Comprehensive Error Rate Testing (CERT) program is adequate, the Government Accountability Office found in report GAO-06-300. CMS found a total error rate of 9.3 percent for Medicare claims in 2004.

• A doctor of osteopathy can be a carrier medical director, and there can be more than two physicians in that role at a carrier, CMS clarifies in Transmittal 136, dated Feb. 1