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E&M guidelines, emergency care rules under HHS review

Physicians say they welcome the government's vow to work with them to address these thorny issues.

By Geri Aston, amednews staff. Aug. 6, 2001.

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Washington -- The government will reassess its effort to develop new Medicare evaluation and management coding guidelines and the federal rules governing treatment of uninsured emergency patients, Health and Human Services Secretary Tommy Thompson announced in late July.

The decision is evidence of a new HHS "culture of responsiveness" to the concerns of physicians and other Medicare participants, Thompson said. Indeed, physicians have pointed to major problems in recent years with both the E&M guidelines and the Emergency Medical Treatment and Active Labor Act.

To work to find solutions to problems in those two areas and others, the Centers for Medicare & Medicaid Services announced the creation of seven "Open Door Policy Committees." One of the panels is devoted to physician issues. Each committee will include senior level agency staff and will meet monthly with relevant interest groups in an effort to build relationships with those organizations and to generate ideas for program reform.

"The goal is to force the institution to be more outward looking," said Tom Scully, CMS administrator.

The AMA said it welcomed the government's effort to reach out. "We are encouraged by this, especially the focus on the documentation guidelines," said Timothy T. Flaherty, MD, AMA chair. "It's been a real concern for all of organized medicine."

Thompson announced his plans to reassess the E&M guidelines at a House Ways and Means Committee hearing. In his testimony, he acknowledged that physicians had found the 1995 and 1997 versions of the documentation guidelines "cumbersome," and he said the agency agreed. He also noted that the government's proposed 2000 version was also causing concern in the physician community. [...]