Part B Insider (Multispecialty) Coding Alert

Published on Sat Dec 09, 2006 PDF

Radiologists could soon have to meet standards

Your doctors can go ahead and make cost-sharing deals with hospitals--but step carefully. The HHS Office of Inspector General (OIG) came out with another advisory opinion (06-22) in which it blessed an arrangement in which a hospital paid a group of cardiac surgeons a percentage of the cost savings they achieve by following certain measures.

But the OIG warned that aspects of the deal, including limiting the use of some surgical supplies, reducing the use of anti-hemorrhaging drug Aprotinin and standardizing some products, could possibly constitute an improper inducement to reduce care or services. The OIG will give this arrangement a pass because it includes some safeguards to keep everyone honest.

The latest OIG opinion -doesn't really stray from the list of other gainsharing opinions it's issued,- says attorney Brian Betner with Hall Render in Indianapolis, IN.

In other news:

- At the last minute, the Senate passed the Consumer Assurance of Radiologic Excellence Act (RadCARE), which would set standards for imaging and radiology, in consultation with -recognized experts.- It also would require the Department of Health and Human Services (HHS) to require licensure for providers of technical services and certify accreditation bodies for imaging and radiology.

Lauding the bill's passage, Sen. Mike Enzi (R-WY) said that between 4 and 7 percent of imaging examinations have to be repeated every year due to improper positioning or technique. Reducing the number of repeat imaging scans by just 1 percent would save Medicare $92 million per year, he noted. It wasn't clear if the House would pass this bill before the end of the 109th Congress.

- Senators John Cornyn (R-TX) and Chuck Schumer (D-NY) and 17 other senators wrote to HHS Secretary Michael Leavitt asking him to make diabetes screening a priority for Medicare patients. They called for -an aggressive collaboration- among agencies to find and screen the 40 percent of Medicare beneficiaries with pre-diabetes.

- Your office could be facing a severe shortage of qualified coding professionals, according to a new survey by the American Health Information Management Association (AHIMA) and the American Hospital Association (AHA). Employers reported -real challenges- finding qualified candidates for open jobs. Three out of 10 were currently recruiting for open positions, and 59 percent had had openings in the past year. Of the employers who had been filling positions, 76 percent said they-d had a difficult, or -extremely difficult- time filling them. Nearly a third had positions open from four to six months.