September 30th, 2010 by RamonaBatesMD in Better Health Network, Health Policy, Opinion, True Stories
Tags: Dr. Ramona Bates, Drop Medicare, Fellow Healthcare Providers, General Medicine, Medicare Boycott, Medicare Non-Participation, Medicare Opt-Out, Medicare Reimbursement, Medicare's Provider Enrollment Chain and Ownership System, Opting Out Of Medicare, PECOS, Senator Blanche Lincoln, Suture For A Living
No Comments »
I opted out of Medicare several years ago. This means I don’t see Medicare patients other than in the emergency room when I’m on unassigned call. I don’t submit bills to Medicare or to those patients. I just let it slide.
Last Wednesday I received the following letter from a large radiology group in my home town:
September 2010
RE: PECOS Enrollment
To our referring physicians and their office managers:
At __________we have begun a project to identify ordering physicians who are not enrolled in Medicare’s Provider Enrollment, Chain and Ownership System (PECOS). Our purpose is to remind physicians of the importance of enrollment to them and to us.
Beginning in January, 2011 those providers filing Medicare claims listing an NPI number on the claim of an unenrolled provider will have their claims denied. This would apply to any claim you send in and to any claim we submit for services provided to your patients because we are required to list your NPI number on our claims. This applies both to patients referred to our private offices and the hospitals where we provide radiology professional interpretations or services.
So, you can see our effort is not purely altruistic. We have a financial interest in reminding you of the importance of PECOS enrollment. In trying to ascertain whether you are enrolled, we are using an online program you can find at www.oandp.com/pecos. Simply enter your NPI number in the entry block and press enter. If you enter a valid NPI number, your name will appear and beside it will be a symbol indicating where Medicare recognizes your PECOS enrollment.
Since Medicare is continually updating the files, we may have accessed the system before your enrollment was completed. We will continue to monitor the situation in hopes you will enroll if you intend to continue seeing Medicare patients. If you have already enrolled or have no plans to enroll, please excuse our intrusion.
Sincerely,
This bothers me. It is not likely that I will be sending them any patients from my office, but that doesn’t mean there won’t be the occasional patient with my name on their chart in the ER. If I need to take a Medicare patient to the operating room from the ER, will the hospital not get paid? Will the anesthesiologist not get paid?
Will my non-participation in Medicare affect my fellow healthcare providers receiving payment? If so, that is just not right. I voiced this concern to Senator Blanche Lincoln shortly after receiving this letter. She agrees with me. Read more »
*This blog post was originally published at Suture for a Living*
September 30th, 2010 by Steve Novella, M.D. in Better Health Network, Health Tips, Opinion, Quackery Exposed, Research
Tags: Anecdotal Evidence, Artificial Sweetener, Aspartame, Caloric Intake, Calorie Consumption, Cancer-Causing Chemicals In Food, Carcinogen, Carcinogenic Potential, Dietetics, Dr. Janet Starr Hull, Dr. Steve Novella, Evidence Based Nutrition, FDA, Fear Mongering, Food Additives, Food and Drug Administration, Food and Nutrition, Food Chemicals, Food Safety, Internet Conspiracy, Internet Urban Legend, Non-Evidence-Based Social Media, Nutrition and Health, Oncology, Pseudoscience, Pseudoscientific Cult, SBM, Science Based Medicine, Science-Based Evidence, Scientifically Implausible Claims, Unverified Speculation, Weight Loss
3 Comments »
If you believe everything you read on the Internet, then is seems that a chemical found in thousands of products is causing an epidemic of severe neurological and systemic diseases, like multiple sclerosis and lupus. The FDA, the companies that make the product, and the “medical industrial complex” all know about the dangers of this chemical, but are hiding the truth from the public in order to protect corporate profits and avoid the pesky paper work that would accompany the truth being revealed.
The only glimmer of hope is a dedicated band of bloggers and anonymous email chain letter authors who aren’t afraid to speak the truth. Armed with the latest anecdotal evidence, unverified speculation, and scientifically implausible claims, they have been tirelessly ranting about the evils of this chemical for years. Undeterred by the countless published studies manufactured by the food cartel that show this chemical is safe, they continue to protect the public by spreading baseless fear and hysteria.
Hopefully, you don’t believe everything you read on the Internet, and you don’t get your science news from email SPAM, where the above scenario is a common theme. While there are many manifestations of this type of urban legend, I am speaking specifically about aspartame — an artificial sweetener used since the early 1980s. The notion that aspartame is unsafe has been circulating almost since it first appeared, and like rumors and misinformation have a tendency to do, fears surrounding aspartame have taken on a life of their own. Read more »
*This blog post was originally published at Science-Based Medicine*
September 30th, 2010 by RyanDuBosar in Better Health Network, Health Policy, News, Opinion
Tags: Accountable Care Organizations, ACP Internist, Bureaucratic Obstacles, Decreasing Reimbursement for Doctors, Doctor-Patient Communication, Dr. Jay Parkinson, Family Practice, Federal Government, Fee-For-Service Reimbursement System, General Medicine, Government Control, Government-run Healthcare, Healthcare Politics, Healthcare reform, Internal Medicine, Medicare, New Practice Models, New Primary Care Models, Patient-Centered Medical Home, Patient-Doctor Relationship, Primary Care, U.S. Healthcare System
No Comments »
Government healthcare reform efforts are picking up the pace to roll out new reimbursement and practice models for primary care.
Medicare is giving out $10 billion for pilot projects encouraging new models of primary care, including the patient-centered medical home. New Jersey just passed legislation to explore the patient-centered medical home. Now, Massachusetts, the early adopter of mandatory health insurance, is now ambitiously planning how to take on the fee-for-service reimbursement system and moving toward accountable care organizations. Under discussion are the scope of power for state regulators, what rules will apply to accountable care organizations, and how to get rid of the existing fee-for-service system.
Blogger and pediatrician Jay Parkinson, MD, MPH, comments about the “bureaucrats in Washington” that, “they’ve decided for doctors that we’ll get paid for strictly office visits and procedures when, in fact, being a good doctor is much, much more about good communication and solid relationships than the maximum volume of patients you can see in a given day.”
Now, it’s those same bureaucrats who are changing the system, trying to find a model that will accomplish just those goals. (CMS Web site, NJ Today, Boston Globe, KevinMD)
*This blog post was originally published at ACP Internist*
September 29th, 2010 by Lucy Hornstein, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Quackery Exposed, Research
Tags: Dr. Lucy Hornstein, Family Medicine, Fifth Vital Sign, General Medicine, Internal Medicine, Not Dead Dinosaur, Pain Control, Pain Management, Pain Perception, Pain Scale, Pain Tolerance, Physical Exam, Primary Care, Signs and Symptoms, Vital Signs
1 Comment »
There’s been a movement afoot for several years now to quantify pain as the so-called “Fifth Vital Sign.” It all started as a well-intentioned effort to raise the level of awareness of inadequate pain control in many patients, but has gotten way out of hand. The problem is that the word “sign” has a specific meaning in medicine that, by definition, cannot be applied to pain.
When you hear us medicos talk about “signs and symptoms” of a disease, it turns out that they are not the same thing. “Symptoms” are things the patient experiences subjectively. “Signs” are things that can be observed objectively by another person.
Headache is a symptom; cough is a sign. Itching is a symptom; scratch marks over a blistery linear rash are a sign. Vertigo, the hallucination of movement, is a symptom; nystagmus, the eye twitching that goes with inner ear abnormalities that can cause vertigo, is a sign. If someone other than the patient can’t see, hear, palpate, percuss, or measure it, it’s a symptom. Anything that can be perceived by someone else is a sign. Read more »
*This blog post was originally published at Musings of a Dinosaur*
September 29th, 2010 by Peggy Polaneczky, M.D. in Better Health Network, Humor, News, Opinion, Research
Tags: Adenovirus-36, Childhood Obesity, Dr. Peggy Polaneczky, LA Times, Obesity and Kids, Obesity Epidemic, Obesity-Causing Virus, Overweight Kids, Pediatrics, The Blog That Ate Manhattan
No Comments »
Finally, the answer to the obesity epidemic. [According to the LA Times], it’s a virus:
New evidence indicates that children who are exposed to a virus called adenovirus-36 are more likely to be obese than those who are not exposed to it, and to be heavier than other obese kids who were not exposed to it, researchers said this week. The virus…is one of 10 bacteria and viruses that have been associated with a propensity for putting on plural poundage.
Maybe this explains why I and two of my sisters all became fat in the same year. Well, that — combined with the fact that we had just moved to a new neighborhood where there were no kids we knew to play outside with, and we started taking a bus to school instead of walking, and “Dark Shadows” had just started, leading us to spend every afternoon after school snacking in front of the TV. But I like to think it was a virus.
*This blog post was originally published at tbtam*
