AMA urges more Medicare coverage for preventive care

Delegates call for coverage of screenings for lipids disorders and diabetes.

By Markian Hawryluk, AMNews staff. Dec. 24/31, 2001.

San Francisco -- With physicians already facing potential reductions in Medicare payments and increases in costs, the American Medical Association will pursue program coverage for Coumadin management and new preventive benefits.

At the recent Interim Meeting of the AMA House of Delegates, physicians voted to seek payment from Medicare and other insurers for the telephone contacts routinely used to evaluate and manage patients taking therapeutic anticoagulants, such as Coumadin (warfarin sodium, made by DuPont Pharma).

Because the dose needed for blood thinning is different for each patient, physicians must carefully monitor patients on Coumadin, especially in the early days of their therapy.

Before the vote, AMA policy already was to support and advocate for payment for case management services and telephone consultations. Many delegates said they thought reimbursement for Coumadin management could be an important first step in carrying out that policy, particularly in light of the growing prevalence of telephone and electronic communication with patients.

"In the future, we're going to have more telephone and e-mail communication and less face-to-face time with [patients]," said Steven Polsley, MD, an Urbana, Ohio, family physician. "More and more, we're going to need to be able to bill for these services." [...]