--
______
From: "TMA Info" <TMAInfo@list.texmed.org>
To: <webmaster@texmed.org>
Subject: TMA: Medicare E&M Guidelines postponed
Date: Wed, 29 Apr 1998 17:46:36 -0500
MIME-Version: 1.0
X-Priority: 3
X-MSMail-Priority: Normal
X-MimeOLE: Produced By Microsoft MimeOLE V4.72.3007.0
Dear Texas Medical Association member:
Thanks to the strongly voiced concerns of TMA, Texas physicians, and
physicians and medical societies around the country, the Health Care
Financing Administration has announced an indefinite delay in the
enforcement of the onerous 1997 Documentation Guidelines for Medicare
Evaluation and Management (E&M) Services. Physicians may continue to use
either the 1995 or the 1997 guidelines until further notice. The guidelines
had been scheduled to take effect on July 1, 1998.
"I have heard that ... physicians believe the new guidelines will divert too
much physician time and attention from patient care to paperwork, " said
HCFA Administrator Nancy-Ann Min DeParle. "I believe we can and must work
together to improve the guidelines so they do not impose requirements in
excess of those associated with clinically appropriate medical
record-keeping practices."
The E&M Guidelines are broken. The TMA House of Delegates voted last week
to "take all necessary steps" to oppose their implementation. TMA will
continue to work with member physicians and HCFA to fix them.
For details, see the May edition of Action, the TMA newsletter, or log on to
the TMA Web site at http://www.texmed.org.
In related news, HCFA Administrator DeParle said that physicians will not be
prosecuted for innocent coding errors.
"Sanctions are intended for physicians who act in 'deliberate ignorance' or
with 'reckless disregard' of the truth or falsity of information," she said.
"For criminal penalties, the standard is that the provider had 'knowing and
willful' intent to defraud the government."
In accordance with the House of Delegates' action, TMA will closely monitor
the government's fraud and abuse operations and "use all available means to
ensure that the burden of proof for fraud and abuse be that of the
government."
If you have any questions about the E&M Guidelines or about fraud and abuse
activities, please contact Rich Johnson, Director of the Division of Medical
Economics, at rich_j@texmed.org. To order a copy of TMA's home study course
on the E&M Guidelines, contact Heather Cusack of TMA's Practice Management
Services Department, at heather_c@texmed.org.
If you have any questions, comments or concerns about TMA's use of e-mail to
communicate with member physicians, please let me know by responding to this
message.
Sincerely,
Steve Levine
Director of Communication
Texas Medical Association
April 29, 1998
----------------------------------
Geffrey H. Klein, MD
----------------------------------
gklein@bcm.tmc.edu
--
----------------------------------
List-owner OB-GYN-L
