DB'S MEDICAL RANTS

Internal medicine, American health care, and especially medical education

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Finding Common Ground: The Intersection of Healthcare Policy and Patient Care

Fixing medicare regulatory reform

Medicare is a pain in the butt! It comes with so many regulations that the money becomes almost irrelevant. Medicare regulatory reform panel looks to cut red tape: Work is under way to implement hundreds of recommendations to relieve the paperwork burden.

Of the 255 recommendations, more than half were directed at the Centers for Medicare & Medicaid Services. The agency has already implemented 17 of those suggestions, and agency officials said work was under way to implement scores of further reforms.

Thompson called the initiative a “great step forward, but only the first step.” He pledged to continue the process of culling the reams of rules that practitioners confront in dealing with government health programs.

“Our work doesn’t stop here. We will continue to carefully consider all of the recommendations and take appropriate steps to promote quality care of all Americans,” Thompson said. “We will continue to focus on the potential impact that reducing regulatory burden may have on patient care as we review existing requirements and consider new regulations.”

I am personally most interested in the E&M guidelines. They are not constructive and just produce ways to document high care. They make physicians documentation experts rather than reward good medical practice. They are indecipherable and uninterpretable by experts! We need a better system and I can only hope we get one.

Physician fees

Senate leaves Medicare pay fix undone: Congress adjourns before addressing the problems with the physician reimbursement rate. Now the new rates will be published. Congress has 60 days to change the published rate, so all is not yet lost. Secretary Thompson of HHS says this is a high priority.

I still cannot understand why the Senate would not address this issue previously. Since the House passed a bill fixing the rate problem twice, I must hope that the new Republican majority Senate will address this successfully. We must follow this issue carefully. Organized medicine has united in working for this issue.

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