Re: Medicare E&M Guidelines postponed
From: Myer S. Bornstein (mborn@massmed.org)
Thu Apr 30 07:38:15 1998
I was told last night, when I attended a meeting about E&M coding and Fraud
and Abuse the implementation of the new guidelines are postponed till an
unknown date.
Myer
>
>From: Geffrey H. Klein, MD
>Sent: April 29, 1998 23:18
>Subject: GEN: Medicare E&M Guidelines postponed
>
>I got this from the Texas Medical Association.
>
>FYI:
>
>From: "TMA Info" <TMAInfo@list.texmed.org>
>Subject: TMA: Medicare E&M Guidelines postponed
>Date: Wed, 29 Apr 1998 17:46:36 -0500
>
>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
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