Physicians want formal Medicare and Medicaid billing compliance guidelines from the federal government, and HHS' inspector general's office wants to supply them.
The inspector general published a notice in the Sept. 8 Federal Register soliciting interest in such guidelines. The guidelines would apply to individual physicians and small medical groups.
HHS has already issued proposed or final compliance guidelines for hospitals, clinical laboratories, durable medical equipment suppliers, hospice, home-health agencies, Medicare HMOs and third-party billing agents.
"We've already sent a letter to the inspector general expressing our qualified support for this," said Robert Doherty, senior vice president of governmental affairs and public policy at the American College of Physicians-American Society of Internal Medicine, a group of 115,000 physicians.
The qualification, Doherty said, is that the guidelines should not put burdensome requirements on physicians who lack the resources of large multispecialty clinics.
Those larger groups are also interested in compliance guidance from the government.
"Our members would like to see more formal guidance," said Brent Miller, vice president of public policy and political affairs at the American Medical Group Association. "If I had the task of being a compliance officer at a large group practice, I would like to be able to act on more than blind faith."
However, the nation's largest physician group, the 292,000-member American Medical Association, remains silent on the government's proposal. A spokeswoman said the AMA would submit comments on the Federal Register notice before the Nov. 8 deadline.
"With hospitals, the industry wanted guidelines," a spokeswoman for the inspector general said. "We hadn't really gotten a response like that from physicians before."
It will be a chore to persuade physicians, who are generally not keen on compliance initiatives, to follow guidelines, some compliance experts said.
"Fundamentally, physicians want to be in compliance but resist the costs," said Brent Saunders, a director at PriceWaterhouseCoopers and president of the Health Care Compliance Association. "A good compliance program is one that promotes efficiency and appropriate coding. It's not just avoiding upcoding, but avoiding undercoding too. The key is enabling physicians to do their job better."