Medicare Compliance & Reimbursement

Plus: Beware of automatic consults in the ED.

President Bush has nominated Department of Health and Human Services (HHS) official Kerry Weems to be permanent administrator of the Centers for Medicare & Medicaid Services (CMS). Currently Leslie Norwalk is Acting Administrator, but she declined to be considered for the permanent position, according to press reports.

Weems has held a variety of top management positions within HHS, including deputy chief of staff, according to a CMS release. If the nomination is approved, he will succeed Mark McClellan, who resigned from the position last fall.

Some observers were surprised to see the nomination go to a government agency veteran with largely financial and budget experience, rather than an outside political personality like former CMS Administrator Tom Scully or former HHS Secretary Tommy Thompson.

Next up: The Senate must now review the President's nomination. ED Physicians: Don't Miss Out On Your Consult Income Emergency department (ED) doctors do consults more often than you'd expect, Caral Edelberg, president of medical management resources for TeamHealth in Jacksonville, FL revealed in her talk, "Advanced ED Compliance Coding Essentials-Physician," at the 2007 American Academy of Professional Coders conference in Seattle.

Warning: Some ED physicians incorrectly think that if the patient's regular physician sends the patient to the ER, it's automatically a consult. This would make almost every ED visit a consult, but it's not correct, Edelberg warned.

Opportunity: But sometimes other physicians will call ED physicians up to the inpatient department to render an opinion about the status of a patient, and then perform intubation or another procedure. In this case, the ED physician should bill a consult, Edelberg maintained.

Note: Because the service described above isn't happening in the ED, you wouldn't use the ED as the place of service (POS), Edelberg cautioned. In Other News... · New York City is offering 1,000 discounted electronic medical records (EMRs) to physicians who have at least 30 percent of their patients enrolled in Medicaid and other state-funded programs, the American Medical Association reports. · Most patients haven't heard anything about EMRs, and they believe their doctors use paper records only. However, patients would be more likely to visit a doctor who used EMRs, according to a survey of 1,000 adults by Kaiser Permanente. And over two-thirds of adults agreed that the benefits of EMRs outweighed any privacy risks.