Medicare, IRS kill doctors by alphabet soup

There's this number called the "NPI." The CMS (Center for Medicare and Medicaid or Can't Manage S(tuff))mandated that any one and any corporation that bills them (for services already done, mind you) needed to add this number, the "National Provider Identifier," by May 23 of this year. (Need I report that quite a few doctors haven't been getting paid properly since? ) Well, out of the blue, the PTB (Powers that Be) sent down a little notice that the names associated with the NPI must now be identical to the ones that the IRS (Infernal Internal Revenue Service) has on file.

The NPI is in addition to the "UPIN" (Unique Provider Identifier Number) the DEA (Drug Enforcement Agency) number, a whole caboodle of state and insurance "identifiers," and that pesky identifier that your mother, father, and husband gave you: your name.

The NPI also had to be acquired for any and each partnership or practice. Some people had one for themselves and one for their practice. Some did not receive their number for months. And, some were unable to get paid even with all the right numbers in the right place.

Now, many will have to start the application process all over if there's a period after the "M" in "M.D." or a space between the letters in their IRS files.

Here's more from "Health IT News:"

Healthcare IT News
By Diana Manos, Senior Editor

06/17/08

WASHINGTON - Just when doctors thought things couldn't get much worse, experts say, the Centers for Medicare & Medicaid Services has thrown another wrench into the already difficult transition to using National Provider Identifiers.

According to a June 11 CMS announcement, doctors will have to reconcile their NPI data with their IRS legal name data in order to get paid.

According to billing experts, this is a disaster waiting to happen. Every aspect of the data must match, including the exact spelling of names, the use of initials and even blank spaces in the data. The slightest discrepancy could send Medicare claims back to the drawing board. Don't go getting married!

After a year-long contingency period, the use of NPIs was required by CMS as of May 23. Both before and since that deadline, doctors have had difficulty getting paid due to a host of complications with CMS and clearinghouse systems, experts say.

Cyndee Weston, executive director of the American Medical Billing Association, said the IRS matching requirement "has blindsided the whole industry."

Weston, who works with small billing companies that submit claims for doctors, said many doctors who began using their NPI identifiers before the deadline have still not received Medicare reimbursements.

"This is going to affect all the doctors we work for. It's going to kill their practices," Weston said.

"I think we haven't seen the worst of this yet. I think we're going to see a big uprising if this continues. No way around it."

Martin Jensen, chief operating officer and chief analyst at the Healthcare IT Transition Group, a consulting group specializing in helping doctors get paid, said physicians aren't getting consistent answers from the CMS or its intermediaries as to what's blocking the claims. The added stress of matching NPI to IRS data is going to compound their troubles.

"This IRS thing is very immediate and one we didn't anticipate," Jensen said. "It's definitely going to set off a cascade of mismatches to data."

The answer most physicians are getting from CMS is to start over with a new NPI enrollment. This could take months, Jensen said. Even doctors who have successfully had their claims paid under NPI could be forced to start over if their IRS data doesn't match, he added.

Are you a provider experiencing difficulty getting paid under NPI? Share your experiences with Senior Editor Diana Manos at diana.manos@medtechpublishing.com.

I don't believe that doctors will actually quit work. Who can, unless our spouse has a good income or we were independently wealthy to begin. What's going to happen is that many more docs will "opt out," or quit accepting Medicare or Medicaid. With the threatened 15%- 20% cut looming over our heads, the extra work and uncertain payment, along with the threat of legal consequences and now no payment) if one comma, period, or space is out of place, I'm not sure I would trust a doc stupid enough to try to play the game.

FDA goes after fraudulent cancer cures

We were just talking about this.

The Washington Post reports

Neil Baker, a retired maker of truck canopies in Helena, Mont., fills about two orders a month for E-Mune through his company, Herbal Remission. It is made from bloodroot, a plant that contains sanguinarine, which has been studied for possible anti-tumor activity. He says one customer's melanoma was cured.

"I really don't know a whole lot about it. All I know is it works," said Baker, 63. "As far as I'm concerned, humanity should have it. But if the FDA doesn't like it, that's okay with me, too."

The FDA's list of "fake cancer cures" is at http://www.fda.gov/bbs/topics/factsheets/fakecancercures.html.

New Bioedge edition available

The weekly newsletter, Bioedge, from the land down under is one of the better bioethics/biotechnology on-line newsletters.

Readers who consider the pro-life movement mainly as a US political matter, may be surprised by the existence of Bioedge, since it is pro-life. The publishers' aim is to:

* to promote evidence-based ethics in medicine
* to promote compassion in medical care
* to highlight the fact that medical excellence is not possible without ethical principles
* to provide high-quality up-to-date information and commentary on bioethics
* to facilitate the participation of health professionals in policy debates on bioethics

This week's headlines include

"Stem cell scientists seek to shed snake oil image"

"California euthanasia lobby scores victory"

"Nature attacks ‘human dignity’"

"Surprise on operating table"

"US Catholic bishops reject embryonic stem cell research"

Coffee drinkers live longer

If true, I may live forever.

According to the Washington Post,

The researchers found that women who drank two or three cups of caffeinated coffee daily had a 25 percent lower risk of death from heart disease during the follow-up (from 1980 to 2004) than non-drinkers. Women also had an 18 percent lower death risk from a cause other than cancer or heart disease compared with non-coffee drinkers.

For men, drinking two to three cups of caffeinated coffee daily was a "wash" -- not associated with either an increased or a decreased risk of death during the follow up, from 1986 to 2004.

The lower death rate was mainly due to a lower risk for heart disease deaths, the researchers found, while no link was discovered for coffee drinking and cancer deaths. The relationship did not seem to be directly related to caffeine, according to the researchers, since those who drank decaf also had a lower death rate than those who didn't drink either kind of coffee.

Election year pro-abortion push

If you don't want your child to suffer, you don't choose Partial Birth Abortion (Intact Dilation and Extraction or "D&X") and you certainly shouldn't complain about State laws concerning prevention of fetal pain during the abortion.

msnbc.com and Self Magazine have teamed up to discuss "When there is no good choice."

In the story, we read about abortions - one at 22 weeks and and one at 30 weeks pregnancy, after two mothers learn that their babies have severe birth defects. While the story spends a lot of space trying to explain that the mothers are having the abortions because they don't want their babies to suffer, the story condemns laws requiring anesthesia, informing the mothers that their children may feel pain during the procedure, or mandating lethal injections to kill the child before dismembering him or her. Of course, we are told how wrong it is to call "D&X" "partial birth abortion," or to ban the procedure itself.

This is a story about the politics of an election year, written to tug on our heart strings rather than inform.

Obviously, I am pro-life, and so, I must be one of those the article calls "anti-abortion." The story claims that I "demonize" the mothers who have abortions at 28 weeks, and mentions that because of George Bush, the Republicans, and "red staters," these women have troubles and the doctors claim that they worry about being charged with breaking the law. However, each woman does abort her child.

The author doesn't seem to notice the irony that she is practicing demonization, herself.

The good news is that the article reports on perinatal hospice, now available across the country:

Today some 60 U.S. hospitals, hospices and crisis pregnancy clinics offer perinatal hospice services; in Minnesota, women seeking to abort fetuses with fatal anomalies are required by law to be informed about hospice as an alternative. “Women appreciate the grieving process and being able to spend time with their babies,” says Dr. Calhoun, vice chair of obstetrics and gynecology at West Virginia University School of Medicine in Charleston. “Perinatal hospice gives women an alternative that is a better choice than abortion.”

Everyone else does it

The American Medical Association and the American Medical Student Association are both up in arms about contact between drug companies and other vendors and doctors and medical students. And yet, no one complains when a New York Times story about the fuss contains advertising. (Free registration required -- is "free" anything undue influence?)

I've said it before, perhaps I can be bought, but not for a pen, some samples or lunch.