Medicare Compliance & Reimbursement

Plus:  Physicians not using even low-cost IT tools, survey finds.

The Centers for Medicare & Medicaid Services (CMS) is forging ahead with its plans to get the new Medicare Administrative Contractors (MACs) up and running.

On Sept. 29, the agency issued a Request for Proposal for three of 15 separate contracts that will be issued in the transition from Medicare fiscal intermediaries and carriers to the MACs. On the same day, CMS announced that it would award the contract as a disputed contract for the specialty Durable Medical Equipment (DME) MAC in Jurisdiction C.

Earlier this year, the Government Accountability Office sustained a protest of the award for DME MAC Jurisdiction C. Now, after taking "corrective action," according to the announcement, CMS is awarding the disputed DME MAC contract to CIGNA Government Services. Originally, CMS had awarded the contract to Palmetto GBA.

Additional information on Medicare contracting reform can be found on the Medicare contracting reform Web site at www.cms.hhs.gov/MedicareContractingReform.

Doctors Not E-Mailing Patients Due To Legal Fears

Not only are providers shying away from electronic medical records and e-prescribing, but they are also not using cheaper, widely accessible information technology in their practices, such as e-mail, a new report reveals.

Fewer than 4 percent of physicians communicate via e-mail with their patients, according to a study that eWeek says will be published in the Journal of Internal Medicine's November issue. Approximately 30 percent of doctors e-mail with other clinicians and only 40 percent use online "use real-time computerized decision support, including government and professional society Web sites and searchable databases," eWeek reports.

But more surprising are the reasons that physicians cite for not using e-mail more often to communicate with patients and other health care providers. Physicians say that they generally don't receive payment for e-mail communications with patients because the communication is outside the patient visit, eWeek says. "Not only will they not be paid for their e-mail tasks, doctors worry that the contents of their e-mails, whether to patients or fellow clinicians, could be used against them in legal cases."

The study also found that: recent medical graduates, as opposed to more experienced physicians, were more likely to use IT tools; doctors in two-person or solo practices were less likely to use IT tools regardless of age; and more than 40 percent of physicians working in academic practices or HMOs used most of the basic IT tools cited in the survey, as opposed to only 12 percent of doctors in solo or two-person practices.

In Other News...

• There's now a companion to the Hobson-Tanner bill in the Senate, thanks to Senators Orrin Hatch (R-UT) and Kent Conrad (D-ND).

The bill, the Medicare Durable Medical Equipment Access Act (S. 3920), aims to ease the effects of Medicare DME competitive bidding for small providers. The House version of the Hobson-Tanner bill (H.R. 3559) has gathered 145 co-sponsors in the House since it was introduced last summer.

• CMS has issued a "special edition" MLN Matters article to help providers bill for influenza vaccines.

The article, SE0667, lists a variety of educational resources to ensure that Medicare fee-for-service (FFS) health care professionals have the information needed to bill Medicare correctly for the Medicare-covered flu vaccines and help promote increased awareness and utilization of the flu vaccine among beneficiaries and providers.

Special Edition article SE 0667 is on the CMS Web site at www.cms.hhs.gov/MLNMattersArticles/downloads/se0667.pdf.