*This is an archive page. The links are no longer being updated.
1992.05.01 :  Advisory Committee on Medicare-Physician Relationships
 
Contact: Bob Hardy (202) 245-6145
May 1, 1992

        The Health Care Financing Administration has released an
advisory report making recommendations to reduce administrative
burdens on physicians under the Medicare program.  The report, by
the Advisory Committee on Medicare-Physician Relationships, looked
into the administrative "hassles" physicians deal with in the
Medicare program.
        "We formed this committee in response to physician concerns
that administrative burdens are taking up the time available for
direct patient care, and that they can contribute unnecessarily to
increased overhead in the cost of practice," said HHS Secretary
Louis W. Sullivan, M.D.  "I anticipate that many of these
recommendations will be helpful in reducing 'hassle factors' and
relieving the sense of frustration that too many physicians feel in
dealing with the Medicare program.
        "Further, the committee's work enhances the president's
broader effort to reduce unnecessary administrative burden in the
U.S. health care system and indeed throughout our economy," Dr.
Sullivan said.
        Acting HCFA Administrator William Toby Jr. said that
several recommendations made in the report are already being acted
on: 
        Carriers are responsible for keeping physicians informed
about Medicare Part B programs and procedures through carrier 

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instructions.  To improve communications with physicians, the
committee recommended that carriers establish physician advisory
committees to review Medicare procedures and consider physician
concerns about the Medicare program.
        Physician advisory committees will be composed of the
carrier and Peer Review Organization medical directors,  presidents
of state medical associations, physicians who treat Medicare
beneficiaries and beneficiaries.  These committees will be in
operation by Oct. 1, *This is an archive page. The links are no longer being updated.
1992.
        Kay E. Jewell, M.D., has joined HCFA's Bureau of Program
Operations to aid with physician-carrier relations.  She will work
with carrier and intermediary medical directors, with HCFA's
medical review units on policy issues and liaison with professional
organizations.
        "The panel has recommended that Medicare-physician
communications be consistent, accurate and timely.  It also
recommended that communications be accomplished with all available
technology to streamline contacts between physicians and the
carriers," Toby said.  "We agree with the recommendation and we
will continue to improve our communications."
        Committee members also expressed concerns about the Peer
Review Process.  HCFA has developed a new strategy--the Health Care
Quality Improvement Initiative--which will move the PRO program
from its emphasis on individual clinical errors to helping
providers improve the mainstream of medical care.  Under 
 
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the new initiative PROs will shift their focus from individual
manual case review to the analysis of patterns of medical care and
outcomes, using an educational rather than a punitive approach.
        The committee recommended that HCFA review the language
used on the Explanation of Medicare Benefits form to ensure that it
is easily understood and presented in a neutral tone--paying
special attention to avoiding language that states or implies a
physician service was unnecessary. 

        HCFA has already reviewed all messages on the EOMB with the
intent to make the language accurate and neutral.  Special
attention has been given to avoiding the implication that 
physician services are unnecessary.

        "We are very appreciative of the diligence of the committee
members.  They covered an ambitious agenda in a short time period,"
Toby said.  "The testimony of professional organizations and the
committee members' own experiences have resulted in an 
excellent report.  HCFA and HHS are now engaging in a substantive
review of the committee's report and its recommendations." 

        In addition, a Practicing Physicians Advisory Council was
named April 24 to advise the HHS Secretary on proposed changes in
regulations and other Medicare actions affecting physicians.  The
committee will provide physicians a greater opportunity to impact
the Medicare program.  The initial meeting of the advisory
committee is scheduled for May ll.

        Secretary Sullivan has also launched an initiative to
reduce administrative costs and burden throughout the health care
system through increased use of electronic data systems.  HCFA is
working with physician, hospital and insurance groups to bring
about changes, especially electronic billing, which will lower
costs and red tape for providers.

        The Medicare-Physician Advisory Committee was chaired by
Nancy E. Gary, M.D., senior medical advisor to the administrator of
the Health Care Financing Administration, and was made up of seven
practicing physicians representing various disciplines including
family practice, internal medicine and surgery.  The advisory
committee focused on better explanations of Medicare policy
decisions, standardizing information required to submit claims, and
creating more effective lines of communications between physicians,
PROs, carriers and beneficiaries. 

        Copies of the Medicare-Physician Relationship Report may be
obtained by calling: Matthew Crow, Health Care Financing
Administration, (202) 245-7874.                                   

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