Magazine article Clinical Psychiatry News

Physician Groups Oppose Medicare Proposal: Cumbersome Enrollment Procedure

Magazine article Clinical Psychiatry News

Physician Groups Oppose Medicare Proposal: Cumbersome Enrollment Procedure

Article excerpt

Fearing additional burdens on their practices, physician groups are asking the Centers for Medicare and Medicaid Services to withdraw its proposal on a new Medicare enrollment policy.

The proposed enrollment form for physicians "contains 12 pages of application and 14 pages of instructions for the application itself," Dr. Douglas Henley, executive vice president of the American Academy of Family Physicians; told this newspaper. Something's amiss, not just with the form, but the whole process, he said. "Physicians fail to see why this is necessary."

CMS' objectives for the proposed process were twofold: to simplify the enrollment policy for health providers and suppliers and to raise the bar on qualifications. The proposed policy would consolidate enrollment criteria but require applicants to meet all federal, state, and local licensure mandates.

Comments on the proposed rule were due by June 24. CMS is reviewing the comments in preparation for the final rule, an agency spokeswoman told this newspaper.

Most of the comments focused on the sore spot of all physician practices: additional hassles.

The American Medical Association in its comments to CMS said that the AMA appreciates the Bush administration's commitment to improve communications with physicians and reduce Medicare's complexity, but that it would be counterproductive for the agency "to impose new and burdensome requirements contained in its proposed rule."

Under the proposal, CMS would require that Medicare providers and suppliers recertify the accuracy of their enrollment information every 3 years, a provision the American College of Physicians referred to as "an onerous, costly experiment."

To avoid a "tail wagging the dog" situation, as well as additional costs to the federal government, CMS should propose provider-specific revalidation intervals after assessing each provider type's potential threat to the Medicare trust fund, ACP suggested.

Currently, providers or suppliers who wish to enroll in Medicare must submit a CMS 855 application form, which is actually a set of four forms, each geared toward a specific provider or supplier type based on the applicant. One part, form 8551, applies to individual health care practitioners such as physicians who wish to bill carriers.

Under the proposed rule, CMS would require all physicians--those currently in, or initially enrolling in the program--to complete the form. This means that physicians who were already billing Medicare before the form was introduced in 1996 would have to complete it, so Medicare has their data on file. …

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