Part B Insider (Multispecialty) Coding Alert

Is your doctor working well with others?

When it comes to preventing future problems and treating chronic ailments, individual practice associations lag behind integrated medical groups, a new study says.

The close collaboration and centralized decision making in integrated medical groups may be behind the better quality of care, according to the study, -Do Integrated Medical Groups Provide Higher-Quality Medical Care than Individual Practice Associations?- The study appeared in the Annals of Internal Medicine.

In a related Health Affairs article, researchers say heart-attack patients don't fare as well when receiving treatment from a solo physician practice as opposed to a larger practice.

Studying more than 116,000 patients- records, researchers from Arizona State University discovered that heart-attack patients receiving treatment from attending solo practitioners were less likely to have cardiac catheterization and angioplasty within 24 hours of a hospital admission and more likely to die than other patients in the same hospital, the article says.

One-day angioplasty rates for larger physician practice's patients were 10 to 26 percent higher and one-day catheterization rates were 10 to 12 percent higher than patients attended by physicians from solo practices, the researchers reveal.

In other news:

- The Centers for Medicare & Medicaid Services awarded a contract for its electronic data center (EDC) for claims processing to Companion Data Services, a subsidiary of Blue Cross Blue Shield of South Carolina, and Electronic Data Systems.

- Miami appears to be ground zero for health care fraud prosecutions right now. A jury found physician Frantz Achille guilty of conspiracy and health care fraud. Achille was a physician at two Miami HIV/AIDS clinics and allegedly forged medical paperwork to receive $2.1 million from Medicare. Patients either never needed the expensive treatments or never received them. The clinic paid patients a kickback to show up, prosecutors said.

Also, Miami physician Julian Torres was arrested Jan. 30, charged with conspiracy and other federal crimes. The owners of Carob Medical Services allegedly paid $20,000 in kickbacks to Torrez to prescribe medical equipment for patients who didn't need it. Carob received around $1 million from Medicare for this equipment.

Finally, Diana Sotto, owner of All Medical Billing Systems, was sentenced to 10 years- imprisonment, followed by three years- supervised release. She helped Miami clinic Project New Hope defraud Medicare of more than $2.8 million from Sept. 2004 to Sept. 2005, billing for HIV/ AIDS medications for patients who actually were HIV-positive but didn't receive the medication.