Medicare physician payment: Time to act on E&M mess

The Centers for Medicare & Medicaid Services needs to scrap its evaluation and management documentation guidelines.

Editorial. July 1, 2002.

It's now up to Health and Human Services Secretary Tommy Thompson to give the final word on Medicare's evaluation and management documentation guidelines. A panel established to advise him on such matters suggested recently what that word should be: scrapped.

Most physicians, it is entirely reasonable to expect, would wholeheartedly agree. Three-fifths of doctors in one AMA survey went on record as saying that E&M documentation is their biggest Medicare paperwork headache.

The AMA, along with nearly 100 state and national organizations in the Federation of medicine, has sent a letter urging Thompson to follow the recommendation of his aptly named Advisory Committee on Regulatory Reform. Such an action on his part would go a very long way to proving his stated commitment to reduce government-imposed hassles in health care.

The battle over E&M documentation is among the longest running, most contentious and convoluted sagas in the history of health care bureaucracy. The various documentation schemes have turned the medical record into a thicket of jottings that doesn't help patients and obscures the data that does. All the while doctors have practiced in fear that mistakes will have them treated as criminals.

As one of Thompson's advisers said last year, clearly without any fear of contradiction, "E&M documentation guidelines are the poster child for regulatory burden." [...]