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Don't
fall behind! Here is some of the most recent news in psychiatry:
·
Medicare Reimbursement for Electroconvulsive
Therapy
· Medication
Errors Related to Potentially Dangerous Abbreviations
· HHS's
Office of Inspector General Issues Report on Psychotropic
Drug Use in Nursing Homes
· HHS’
Office of Inspector General Issues Report on Medicare Part
B Payments for Mental Health Services
· OIG
Issues Special Advisory Bulletin Addressing Business Consultants
Practices
Medicare
Reimbursement for Electroconvulsive Therapy
According to this report, "current research indicates
that the administration of multiple monitored ECT is not clinically
recommended. As a result, OIG recommends that the Centers
for Medicare and Medicaid Services (CMS) consider the appropriateness
of CPT code 90871 and take into account that this code should
rarely be used. The CMS concurs with OIG’s recommendations."
To view
the report, visit http://oig.hhs.gov/oei/reports/oei-12-01-00450.pdf.
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Medication
Errors Related to Potentially Dangerous Abbreviations
This alert addresses medication errors related to the use
of "dangerous abbreviations and dose expressions"
in prescriptions. The report gives examples of particularly
problematic abbreviations and other dangerous practices. The
alert also provides specific risk reduction strategies.
To view
the alert, visit http://www.jcaho.org/edu_pub/sealert/sea23.html.
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HHS's
Office of Inspector General Issues Report on Psychotropic
Drug Use in Nursing Homes
The OIG’s
Office of Evaluation and Inspections has issued a report on
psychotropic drug use "to assess the extent and nature
of inappropriate psychotropic drug use in nursing homes and
how it relates to chemical restraints." The study concluded
that psychotropic drug use in nursing homes is generally appropriate.
Specifically, the study found "eighty-five percent of
residents’ psychotropic drug use is medically appropriate.
Nearly all have the potential to benefit functionally from
their drug therapy and are using the drugs within Medicare
guidelines for appropriate use. Another 8 percent of residents
are using psychotropic drugs inappropriately. These drugs
are inappropriate for one or more of the following reasons:
the dose is too high because appropriate dose reductions are
not followed; there is unjustified chronic use of the drug;
there is no documented benefit to the resident; the wrong
type of drug is being given for a particular diagnosis; and
there is unnecessary duplicate drug therapy. The use of psychotropic
drugs as an inappropriate chemical restraint does not appear
to be widespread….Finally, for 7 percent of residents,
reviewers could not determine the appropriateness of their
psychotropic drug use due to insufficient medical record documentation".
The OIG noted concern with the lack of adequate documentation
for residents’ psychotropic drug use; in response to
that concern, the Centers for Medicare & Medicaid Services
(CMS), noted that "training related to psychotropic drug
use and related documentation issues is already underway or
planned".
Psychiatrists
may find the report useful as a review of the federal guidelines
related to the appropriate use of psychotropic medications
nursing homes.
To view
the report, visit: http://oig.hhs.gov/oei/reports/oei-02-00-00490.pdf.
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HHS’
Office of Inspector General Issues Report on Medicare Part
B Payments for Mental Health Services
The OIG’s
Office of Evaluation and Inspections (OEI) has issued a report
on Medicare payments for mental health services. According
to the OEI, "Medicare allowed $185 million in 1998 for
outpatient mental health services that were medically unnecessary,
billed incorrectly, rendered by unqualified providers, and
undocumented or poorly documented, according to this study.
We recommended that HCFA identify problematic mental health
services for pre-payment edits or post-payment medical review,
promote provider awareness of documentation and medical necessity
requirements for Part B mental health services, develop a
specific and comprehensive listing of psychological assessments
that can be correctly billed under psychological testing code
96100, and require carriers to initiate recover of payments
for the inappropriate outpatient mental health services identified
in this report. The HCFA concurred with our recommendations."
To view
the report visit: www.hhs.gov/oig/oei/reports/a522.pdf
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OIG
Issues Special Advisory Bulletin Addressing Business Consultants
Practices
The Department
of Health and Human Services Office of Inspector General (OIG)
has issued a SPECIAL ADVISORY BULLETIN addressing practices
of business consultants which may expose physicians to potential
legal liability.
The basis
for the Bulletin was an OIG investigation of consultants who
ran billing workshops and seminars offering advice on compliance
with healthcare billing laws and regulations.
The following
documents discuss the specific billing advice that pose a
risk to physicians:
OIG –
Special Advisory Bulletin, Practices of Business Consultants,
www.hhs.gov/oig/frdalrt/consultants.pdf
Testimony of Lewis Morris, Assistant Inspector General for
Legal Affairs, www.hhs.gov/oig/testimony/2001/062801lm.pdf
GAO Report, Consultants’ Billing advice May Lead to Improperly
Paid Insurance Claims, www.gao.gov/new.items/d01818.pdf
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