Medicare Compliance & Reimbursement

Plus: Get ready to see less for Moh's

Medicare launched a 120-city bus tour this summer to publicize available screenings and immunizations, reports The Wall Street Journal. Fewer than one in 10 Medicare recipients is getting all the screenings and immunizations recommended by public health experts, says the Centers for Medicare & Medicaid Services. One third of Medicare benes didn't get free flu shots in 2005.

Many seniors are unaware of Medicare's preventive-care benefits because until recently, the program spent just 5 percent on such services. Now, seniors can get free or low-cost glaucoma screenings, medical nutrition therapy, cardiovascular and diabetic screenings, smoking and tobacco-cessation counseling, and ultrasound screening for aortic aneurysms in at-risk patients.

Under-utilized services that have been available for years include vaccines for flu, pneumonia and hepatitis B; mammograms; tests for cervical and prostate cancer; bone-density screenings; and training for diabetes self-management.

To help seniors learn more about co-pays for such services, The Wall Street Journal recommends visiting MyMedicare.gov or AARP's web site, www.aarp.org.

In Other News...

• Heads up: A little-noticed proposal in the 2008 Medicare fee schedule could slash your reimbursement for Moh's Micrographic Surgery (17311-17315). Medicare wants to apply the Multiple Procedure Payment Reduction if your doctor performs more than one Moh's procedure in the same session.

Medicare believes the costs will be lower for multiple procedures because some services will overlap. But this reasoning doesn't apply to Moh's, argued Thomas Stasko, director of Moh's for Vanderbilt University Medical Center in Nashville, in written comments.

In particular, the doctor must perform separate pre-service positioning, pre-service scrub, dress and wait time, and intraservice work for each separate tumor, Stasko insisted. And any reconstructive procedures after the Moh's must also stand on their own.

• Doctors won't just restrict access to Medicare patients if Medicare rates go down--they'll also slim down the size of their staffs, according to a new survey from the Medical Group Management Association.

Some 57 percent of physicians said they would have to reduce staff health benefits to stay afloat. And 44 percent would cut "administrative staffing levels." A third of doctors would cut clinical staffing levels.

But only 9 percent would cut the number of physicians in their practices, reports CQ HealthBeat.