CMS team takes aim at physicians' Medicare beefs

The group checks off several items on its list of doctor complaints and eyes new challenges.

By Markian Hawryluk, AMNews staff. Jan. 7, 2002.

Washington -- Its issues aren't as glamorous as Medicare reform or a payment update fix, but an internal team at the Centers for Medicare & Medicaid Services is making concrete gains in its effort to reduce everyday hassles for practicing physicians.

The Physicians' Regulatory Issues Team was born out of complaints that physicians face an extraordinary volume of complex Medicare regulations. PRIT initiated the Physician Issues Project, the identification of the 25 issues most often cited as getting in the way of physicians trying to provide care to their patients.

The Practicing Physicians Advisory Council, a panel of doctors that advises CMS, chose seven of those issues as top priorities.

"These are major problems," said Douglas Wood, MD, a Rochester, Minn., cardiologist who serves on PPAC. "They're ones that, if resolved, would help the people who take care of patients on a daily basis and would help to remove some of the barriers to good patient care."

Much of the progress in achieving at least partial resolution of those priorities has been attributed to Barbara Paul, MD, PRIT director and CMS medical adviser.

"In February, I indicated that I thought that by the end of the year, physicians would see some tangible improvements in the program," Dr. Paul said.

"I'm hoping that physicians are beginning to see some of those. We've been working hard to identify issues, chase them down, and create solutions that are truly tangible to the practicing physician."

PRIT has helped CMS streamline its requirements for certificates of medical necessity, the reordering of supplies for diabetics, and the ordering of laboratory tests. It has taken steps to reduce carrier denials for preoperative screenings and follow-up visits with cancer patients. And its work has led to greater clarity and simpler forms for issuing advance beneficiary notices. [...]