CMS help lines, bulletins offer little help, GAO says

Medicare carriers often provide inaccurate or incomplete responses to physician queries.

By Markian Hawryluk, AMNews staff. March 18, 2002.

Washington -- Physicians frustrated with their inability to get straight answers from Medicare can at least take heart that a government watchdog agency feels their pain.

A new report from the General Accounting Office concluded that information given to doctors by Medicare carriers is often difficult to use, out of date, inaccurate or incomplete.

"Physicians cannot rely on carrier bulletins, call centers or Web sites to meet their information needs," the GAO said in the report.

Carriers, with whom the Centers for Medicare & Medicaid Services contracts to administer the Medicare program, generally rely on bulletins to communicate program information to physicians. But those bulletins are poorly organized and contain dense language, GAO said.

Carriers are required to issue the bulletins at least quarterly but have wide latitude in how those documents are structured. GAO found that many did not have a table of contents and did not categorize instructions by subject matter, forcing physicians to scan bulletins typically in excess of 50 pages.

In several instances, the documents gave notice of new requirements after their effective date or with too little advance warning for physicians to meet implementation deadlines, the GAO found.

Many physicians have complained about the complexity of the Medicare bulletins and the difficulty of finding the relevant information.

"The bulletin is really not very helpful," said Amilu Rothhammer, MD, a surgeon in Colorado Springs, Colo., and a member of the Dept. of Health and Human Services' Practicing Physicians Advisory Council. "I would guess that one bit of communication that comes by mail is hardly even read by most of the physicians." [...]