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Nixed Medicare consultation codes force doctors to make cutbacks

Thousands of physicians say they have been forced to adopt a number of damaging cost-cutting measures as a result of Medicare discontinuing its use of consultation codes, a policy adopted by the Centers for Medicare & Medicaid Services that took effect on Jan. 1. Consultation codes are used most frequently by specialists after patients are referred to them by primary care physicians. Starting this year, Medicare eliminated the use of all consultation codes except telemedicine consults. It directed physicians instead to bill for the visits using only evaluation and management codes that apply. According to a June 18 letter sent to CMS by the American Medical Association and more than 30 other physician organizations, the agency predicted that no specialty would see Medicare revenues decline by more than 3% because of the change. CMS also had stated that another goal was to reduce confusion and administrative burdens associated with filing consultation codes. But the AMA said th ...

Liability cap faces legal challenge in West Virginia

West Virginia physicians are planning to defend the state's medical liability cap after the high court there in April accepted a case challenging the law's constitutionality. The 2003 statute limits noneconomic damages in medical liability cases to $250,000 in most cases and $500,000 in actions involving serious or traumatic injuries. The case before the West Virginia Supreme Court of Appeals stems from a $1.6 million jury verdict in 2008 to James D. MacDonald and his wife after he was diagnosed with severe muscle damage following pneumonia treatment at City Hospital in Martinsburg, W.Va. MacDonald, who had an earlier kidney transplant, alleged that the hospital and his treating physician put him on a drug regimen that worsened his kidney condition and caused the muscle damage. The doctor and hospital denied any negligence. A Berkeley County trial court reduced the noneconomic portion of the award, which was $1.5 million, to the $500,000 cap. The court also rejected arguments ...

Medicare physician pay cut reversal in Senate's hands

When Congress returns from its Memorial Day recess on June 7, the Senate will be racing the clock to stem damage from a 21% cut in Medicare physician pay that officially went into effect June 1. This is the third time this year the cut has gone into effect before it could be reversed, and physician organizations say they are growing increasingly frustrated by what they perceive as a lack of urgency on the part of lawmakers to fix the situation in a more permanent fashion. As it did the two previous times, the Centers for Medicare & Medicaid Services said it would instruct Medicare contractors to hold June claims for 10 business days, giving the Senate more time to pass the House bill before the program starts sending doctors' payments at the reduced rate. The extension runs out after June 14. * The bill's other priorities * See related content * Topic: Medicare The extenders bill that the House approved on May 28 includes a 19-month patch, under which doctors wou ...