Medicare Education and Regulatory Fairness Act: Necessary and overdue relief

A proposed federal law would blunt Medicare's worst tactics when investigating alleged physician billing errors.

Editorial. April 9, 2001.

Physicians will immediately spot two striking words in the title of the Medicare Education and Regulatory Fairness Act, introduced recently in Congress.

Education and fairness have sorely been missing from Medicare's approach to dealing with doctors. It's incredible that an act of Congress was needed for the government to provide reasonable due process and to make clear what its own rules are, but so be it. This is a good piece of legislation that merits the active support of all physicians.

The AMA and more than 50 physician organizations, as well as allied health groups, are already on record in favor of its passage. That support includes AMA testimony on Capitol Hill last month, in which AMA President-elect Richard F. Corlin, MD, called such regulatory reform "a top priority for America's physicians, who want to spend time on what matters -- patient care -- rather than paperwork." He warned that "the growing complexity of [Medicare's] rules and policies is driving physicians from the program."

The figure often cited by the AMA is that Medicare's rules run more than 110,000 pages -- for scale, think 81 paperback copies of War and Peace stacked one atop another -- and the result is a wasteful, mystifying and, at times, coercive system.

Countless hours of physician productivity are lost to record keeping to meet Medicare demands. Physicians who seek to stay out of harm's way can't get the answers they need.

If a doctor does come under suspicion of committing errors -- instances of actual physician fraud are very rare -- the situation can quickly turn into a nightmare. (The AMA has cited one cardiologist whose practice ended up spending $44,000 to free up $50,000 withheld during an audit.) [...]