An all-too-familiar story: A practice is handed a bill in the amount of four million dollars after an audit by a Medicare contractor alleging overpayments. The practice challenged the audit and proved that the contractor made a mistake interpreting medical coding. The good news? The four million was reduced to $2,810. The bad news? It took the practice two years to rectify the mistake at a cost of $350,000. What is going on here?
The concern over the "difficult" or disruptive Doctor has not caught just the attention of the New York Times but also the AMA and JCAHO as well as a host of other medical societies and authors. A number of problem areas and suggested solutions have been proposed.
Physicians should be aware that this new statute has serious limitations and its interpretation by the courts is, as yet, unknown and could be further limiting. In that regard, caution is paramount. However, having said that, physicians cannot ignore the opportunity for openness and increased patient satisfaction that this statute provides.