Physician groups ended up looking like the bad guys recently when they got defensive about the American Association of Retired Persons' partnership with the federal government to combat Medicare fraud.
The AARP's plan would train beneficiaries to spot shenanigans on their billing statements from Medicare. AARP volunteers would also teach their peers how to resolve incorrect billings with providers and how to report suspected fraud to the government (March 1, p. 16).
Instead of supporting a plan to root out fraud, the physicians cried that it would create an army of overzealous and uninformed beneficiaries itching to find fraud around every corner.
The American Medical Association shot at the effort with particular vitriol.
"The massive 'phone-in' Medicare fraud campaign that the federal government and AARP are mounting, sending our patients out to fight Medicare fraud with little more than a baseball cap, magnifying glass and an 800 number, trivializes real fraud and creates an adversarial tone in every physician-patient encounter," AMA President Nancy Dickey, M.D., said in a statement. "This campaign is a public relations gimmick that will be counterproductive."
Statements from the Association of American Physicians and Surgeons and the American College of Physicians-American Society of Internal Medicine echoed that sentiment.
The American Hospital Association, however, seized the opportunity to cozy up to the AARP, praising the effort.
"We appreciate the AARP's concern about this matter and and will continue to work with them to responsibly address the issue of healthcare fraud," the AHA said.
Looks like when the public relations boat sailed, the physicians were left on the dock.
Much ado. . . Although he works in a city obsessed with leaks of confidential information, Rep. William Thomas (R-Calif.), chairman of the House Ways and Means Committee's health subcommittee, has taken the paranoia to an extreme.
At a hearing last week to receive the Medicare Payment Advisory Commission's annual March 1 report to Congress, Thomas lashed out at MedPAC Chairwoman Gail Wilensky, a Thomas ally, for leaking information on the report to the public.
Thomas' ire was related to an article a week before in CongressDaily, a twice-a-day newsletter read widely on Capitol Hill. The article came out after Wilensky had briefed journalists on the contents of the report, as the MedPAC chairman traditionally does.
The difference this year was that MedPAC neglected to specify that in return for the advance briefing, journalists should not write about the report until the official March 1 release date. As a result, CongressDaily believed it wasn't violating any ground rules by publishing its article.
But Thomas' anger may be a bit misplaced, since the newsletter wasn't exactly disclosing top-secret information. All of MedPAC's recommendations are debated and voted on in a series of public meetings leading up to the March 1 report.
Source of inspiration. A bill that would make it illegal for nursing homes to "dump" Medicaid patients has found an ally in the industry.
Vencor, a Louisville, Ky.-based operator of more than 300 nursing homes nationwide, has come out in support of the bill, proposed by Reps. Michael Bilirakis (R-Fla.) and Jim Davis (D-Fla.).
Ironically, the bill banning the eviction of nursing home residents on Medicaid was somewhat inspired by Vencor. Last year, the company told 10 residents on Medicaid that they would have to leave its Tampa, Fla., facility because Vencor was exiting the Medicaid market in Florida and eight other states (April 13, 1998, p. 4). Patients and their advocates accused the company of evicting residents to make way for more lucrative, privately insured patients.
Florida fined Vencor $260,000, but HCFA, after reviewing the case, decided not to sanction the company. Vencor last year hired a national law firm to review its Medicaid discharge practices (June 6, 1998, p. 4).
Vencor spokeswoman Susan Ross says the company supports the Bilirakis-Davis bill because it would establish consistent guidelines and regulations across states.
"(Legislation) would protect the rights of Medicaid beneficiaries and those of the nursing homes, whose participation in Medicaid is entirely voluntary," Ross says.
Quotable. "Rep. Charles Norwood (R-Ga.) will need more than an army of special-interest groups to revive his healthcare agenda in 1999. He'll need Lazarus."
-Karen Ignagni, president of the American Association of Health Plans, on Norwood's efforts to revive the patient-protection bill that failed last year.
Hitting away. Healthcare information systems/technology organizations are naturals to create words with their acronyms-the "S" and "T" make the most-valuable list on TV's "Wheel of Fortune," and the "I" supplies vowel power.
Companies and groups generally have resisted playing off their shortened names. There is no music motif, for example, surrounding the College of Healthcare Information Management Executives (CHIME) nor joyful noise associated with the Healthcare Information and Management Systems Society (HIMSS).
But a Reston, Va.-based company, DynCorp, has no such restraint. Its marketers have dressed the company's Healthcare Information Technology Services division in the full uniform of America's pastime, including a press kit in which seven starters on the executive team assume classic poses for HITS baseball cards. The backs of the cards have stats on experience, education and expertise.
