Part B Insider (Multispecialty) Coding Alert

Published on Thu Jul 19, 2007 PDF

Electronic records may prevent fraud, but they don't improve care

Cancer practices are doing fine, insists the HHS Office of Inspector General (OIG) in the latest of a long line of reports on oncology drugs.

The OIG surveyed a dozen oncology practices and found that nine of them could buy 15 cancer drugs at the Medicare rate or cheaper. The other three practices, however, had to pay more than the Medicare rate for at least half of those drugs.

Unfortunately, 11 out of 12 practices didn't have any way to track the costs of providing the drugs, apart from the drugs themselves. That means the OIG was unable to tell whether the Medicare payments were enough to cover all the other costs that go along with providing the drugs.

Bottom line: The newest report -provides additional evidence of the adequacy of Medicare payment for Part B drugs used in cancer treatment,- said the Centers for Medicare & Medicaid Services (CMS).

In other news:

- Electronic medical records (EMRs) could aid in preventing fraud if they included 14 safeguards, according to a new report from RTI International in Research Triangle Park, NC. These include audit functions, provider identification, user access authorization, and safeguards for evaluation and management coding.

Most doctors don't commit fraud and shouldn't be burdened by safeguards aimed at the few who do, notes the RTI report, prepared for the HHS Office of the National Coordinator for Health Information Technology. So any fraud protections in EMRs should also benefit every physician by making their coding more accurate.

- But EMRs don't necessarily improve the quality of your doctor's care, according to a study in the July 9 Archives of Internal Medicine. Researchers examined more than 50,000 patient records from more than 2,500 physician offices from the National Ambulatory Medical Care Survey.

The researchers found -no significant difference- between visits with or without EMRs for 14 out of 17 quality indicators. Doctors with EMRs performed much better on two indicators: avoiding routine urinalysis during exams and avoiding benzodiazepine use for depressed patients. But the EMR doctors performed much worse on one measure, prescribing statin to patients with hypercholesterolemia.

- Six leading medical specialty societies are co-sponsoring a symposium on breast cancer prevention, to be held Sept. 7-8 at the San Francisco Marriott. The Breast Cancer Symposium will bring together surgical, medical and radiation oncologists to discuss new research and help doctors apply new discoveries to treating people with breast cancer.