U.S. Warning to Hospitals on Medicare Bill Abuses

CAL/AAEM News Service calaaem.news.service1 at gmail.com
Fri Oct 12 14:37:45 PDT 2012


 
October 8, 2012
 
Subject: U.S. Warning to Hospitals on Medicare Bill Abuses 

American Academy of Emergency Medicine

To all AAEM Members:
The Academy has been made aware that there is intense scrutiny on EM billing practices. Note the NY Timesarticle published on 9/25/12 by Abelson and Creswell calling attention to the increased billings. A recently completed investigation by the Office of the Inspector General (OIG) has identified emergency physicians as one of the groups that have increased their coding levels dramatically over the last decade.
On page 10 of this report, you will note that ED visits account for the fifth highest number of EM payments by Medicare. The graphic demonstrates that level 5 billing for ED visits has increased 21%. Contrary to what some believe, emergency medicine is a major player in the economics of Medicare physician payments. The report indicates that the OIG has already identified 1,700 physicians who bill EM level 4 and 5 at least 95% of the time. Emergency medicine ranks third — having 10% of the physicians billing in this manner.
The OIG has given this list of 1,700 physicians, which includes 170 emergency physicians, to CMS who has forwarded this to the Medicare Administrative Contractors for investigation. Additionally, CMS will prepare their own report on the 5,000 top physician billers. The bottom line is to be advised that EM physicians are under the microscope. This also highlights the ability of each emergency physician to have access to the books in order to see what is being billed in your name as the Feds do hold the individual physicians accountable.

AAEM Board of Directors


 
Bryan Sloane
Deputy Editor, CAL/AAEM News Service
 
Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service

Contact us at: calaaem.news.service1 at gmail.com

For more articles, visit our archives. 

To unsubscribe from this list, visit our mail server.

Copyright (C) 2012. The California Chapter of the American Academy of Emergency Medicine (CAL/AAEM). http://www.calaaem.org. All rights reserved.

CAL/AAEM, a nonprofit professional organization for emergency physicians, operates the CAL/AAEM News Service solely as an educational resource for physicians. Dissemination of an article by CAL/AAEM News Service does not imply endorsement, agreement, or recommendation by CAL/AAEM News Service, CAL/AAEM, or AAEM.

Follow CAL/AAEM on Facebook and Twitter:
 
     
-------------- next part --------------
An HTML attachment was scrubbed...
URL: http://maillists.uci.edu/mailman/public/calaaem/attachments/20121012/2656c0f0/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image007.jpg
Type: image/jpeg
Size: 19903 bytes
Desc: not available
Url : http://maillists.uci.edu/mailman/public/calaaem/attachments/20121012/2656c0f0/attachment-0003.jpg 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image008.jpg
Type: image/jpeg
Size: 941 bytes
Desc: not available
Url : http://maillists.uci.edu/mailman/public/calaaem/attachments/20121012/2656c0f0/attachment-0004.jpg 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image009.jpg
Type: image/jpeg
Size: 885 bytes
Desc: not available
Url : http://maillists.uci.edu/mailman/public/calaaem/attachments/20121012/2656c0f0/attachment-0005.jpg 


More information about the CALAAEM mailing list