Part B Insider (Multispecialty) Coding Alert

Published on Thu Jan 18, 2007 PDF

Now's your chance to comment on proposed standards

Yet another organization wants to examine your practice's quality and see how you measure up--but at least this time you get some say in the process.

The National Committee for Quality Assurance (NCQA) released an expanded set of measures, guidelines and technical specifications based on NCQA's HEDIS tool to assess physician practice quality. 

The evaluation points include 25 measures of clinical quality at the physician level and 50 indicators. The specifications also set standards for the measurement of the cost of care and guidelines for collecting data on quality. And NCQA also provides standardized data collection methods that account for electronic medical records (EMRs) and episode-grouping software. You can comment on the proposed measures by going to www.ncqa.org/.

NCQA's existing measures already have been included in other programs, including the National Quality Forum-s National Voluntary Consensus Standards for Physician-Focused Ambulatory Care.

- The National Coalition for Cancer Survivorship (NCCS) and the American Society of Clinical Oncology (ASCO) submitted friend-of-the-court briefs to the D.C. Circuit Court of Appeals. They-re opposing a claim by the Abigail Alliance for Better Access to Developmental Drugs that terminally ill patients should have the right to access drugs that aren't approved by the Food and Drug Administration once they-ve been tested in Phase I clinical trials. ASCO and NCCS argue that this right doesn't exist, and Phase I trials don't provide enough assessment of safety or effectiveness to make drugs available.

- Think the Centers for Medicare & Medicaid Services (CMS) should pay for vagus nerve stimulation to treat patients with chronic depression? Now's your last chance to get your views heard. CMS issued a proposed coverage determination that says vagus nerve stimulation isn't -reasonable and necessary- for treatment of resistant depression. For more information, and to submit comments, go online to http://cms.hhs.gov/mcd/viewdraftdecisionmemo.asp?id=195.

- Fraud in prescription drugs includes kickbacks paid to physicians for prescribing a particular drug, as well as drugs being marketed for -off-label- uses not approved by the FDA, the HHS Office of Inspector General testified at a Feb. 9 hearing of the House Oversight and Government Reform Committee.

- Atlanta, GA database company Lodestone Solutions says it's launched a directory of 640,000 primary email addresses of practicing physicians. The Physician Email Solutions Masterfile is the largest multi-channel integrated database to service the pharmaceutical, healthcare, insurance & medical device industry, Lodestone says.