Rules That Rankle
MS regulations touch every part of the health care system. They affect financial transactions, medical records privacy, and the delivery of care. Health care providers and insurers complain the rules are overly complex and burdensome, thus taking valuable time away from patient care. Here's a sample of their biggest complaints.
- Medicare evaluation and management documentation guidelines. Physicians are required to keep records on a patient's visits to ensure Medicare is properly billed and to reduce problems with claims processing. Physicians complain that the guidelines don't make sense, often use inaccurate terms and rarely ask the right medical questions.
- Outcome Assessment and Information Set. Used to monitor quality of home health care and adjust Medicare payments, the form includes 80 questions about clinical outcomes. Providers say it takes 90 minutes to complete the form and only 20 questions are used to calculate payments.
- The 1996 Health Insurance Portability and Accountability Act required CMS to develop rules governing medical records security. The original rule required physicians, hospitals and pharmacies to obtain written consent before using or disclosing patients' health information. The Bush administration has proposed instead simply requiring health care entities to notify patients in writing of how personal medical information may be used or disclosed.
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