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Part B Insider (Multispecialty) Coding Alert

Physician Notes:

Vital Physician Info Goes Online

Published on Fri Jul 18, 2003

CMS Broadcast Will Cover Medicare Rules on New Patients

More information on more physicians is now accessible to Medicare beneficiaries, thanks to the Centers for Medicare & Medicaid Services' recent expansion of its National Participating Physician Directory.
 
CMS on July 8 said the directory now includes physicians' medical school, their year of graduation, information on their board certifications, their gender, the hospitals at which they have admitting privileges, their office phone number, and any foreign languages they know. Previously, the database only included names, addresses and specialties, CMS says.
 
Heads up: The directory - which is updated monthly - will soon say whether a physician is accepting new Medicare patients.
 
To see your information in the directory, go to http://63.241.27.97/Physician/Search/PhysicianSearch.asp.
 

  • Bonus payments to physicians in rural areas didn't serve as the incentive that Congress intended, because many physicians didn't even collect the bonuses, according to a study in the July/August issue of Health Affairs (Vol. 22, No. 4). Bonus payments under a Congressionally mandated program accounted for less than 1 percent of spending physician services in non-metropolitan, underserved counties. The bonuses increased from 1992 to 1996, then decreased 13 percent in 1998.
     
  • If one of your patients ever complains to a quality improvement organization, she'll learn more about what was decided in the subsequent review than ever before.
     
    A Medicare QIO must tell a complaining beneficiary, at a minimum, whether or not the QIO believes the beneficiary's treatment met "professionally recognized standards of healthcare," the U.S. Court of Appeals for the D.C. Circuit ruled June 23. The court's opinion in Public Citizen Inc. v. Dept of Health and Human Services (No. 01-5294) affirmed a 2001 trial court decision that had been stayed pending appeal.
     
    QIOs, previously known as peer review organizations, currently tell beneficiaries only that their complaint has been received and examined and that the QIO will take unspecified appropriate action if warranted.
     
  • CMS renewed the charter for the Practicing Physicians' Advisory Council until June 12, 2005, in the June 27 Federal Register (Vol. 68, No. 124.)
     
    You should submit Medicare Secondary Payer claims with multiple primary payers on paper for now, because the 837 form is unable to handle multiple primary-payer information, CMS said in Transmittal B-03-050.
     
    The old site that allowed physicians to look up local medical review policies, lmrp.net, has gone down. But in its place, CMS put up a new site that allows you to search LMRPs and national coverage policies, at www.cms.hhs.gov/mcd.

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